参附注射液对脓毒症患者血清胃蛋白酶原Ⅰ、Ⅱ和胃泌素17的影响:单中心随机对照实验

Effect of Shenfu injection on serum pepsinogenⅠ,Ⅱand gastrin 17 in patients with sepsis:a single-center randomized controlled trial

目的探讨参附注射液对脓毒症患者血清胃蛋白酶原(pepsinogen,PG)Ⅰ,PGⅡ和胃泌素17(gastrin 17,G17)的影响。方法本研究为单中心随机对照临床试验,选取2021年6至2022年12月收治于徐州医科大学附属医院重症医学科的脓毒症合并急性胃肠损伤(acute gastrointestinal injury,AGI)患者,按照随机数字表将患者分为参附组和对照组。所有患者均根据指南给予脓毒症常规治疗,包括治疗原发病、液体复苏和对症治疗等,参附组在常规治疗同时加用参附注射液治疗,记录并比较两组患者治疗前以及治疗第3天和第7天的胃肠损伤指标(PGⅠ、PGⅡ、G17和AGI分级)、机械通气时间和住ICU时间。结果本研究纳入89例脓毒症合并AGI患者,分为参附组44例,对照组45例。治疗前,两组患者血清PGⅠ、PGⅡ和G17比较差异无统计学意义(均P>0.05)。治疗第3天,参附组血清PGⅠ低于对照组[(156.46±62.90)µg/L vs.(183.03±45.44)µg/L,P<0.05],血清PGⅡ和G17水平差异无统计学意义(P>0.05)。治疗第7天,参附组血清PGⅠ、PGⅡ、G17低于对照组[(107.97±23.18)µg/L vs.(154.78±33.11)µg/L;(10.73±5.62)µg/L vs.(13.83±6.30)µg/L;(7.31±3.20)pmol/L vs.(9.29±3.92)pmol/L],差异均有统计学意义(均P<0.05)。与对照组比较,参附组AGI分级明显降低,机械通气时间和ICU住院时间均明显减少,均差异有统计学意义(均P<0.05)。结论参附注射液可以改善脓毒症AGI患者的血清胃功能,降低AGI分级,减少机械通气时间和ICU住院时间。

Objective To investigate the effect of Shenfu injection on serum pepsinogen(PG)Ⅰ,PGⅡand gastrin 17(G17)in sepsis patients with acute gastrointestinal injury(AGI).Methods From June 2021 to December 2022,a single-center randomized controlled clinical study was conducted to select patients with sepsis complicated with acute gastrointestinal injury(AGI)admitted to the ICU of the Affiliated Hospital of Xuzhou Medical University.Patients were randomly(random number)divided into Shenfu group and control group.All patients were given routine treatment of sepsis according to the guidelines,including treatment of primary disease,fluid resuscitation and supportive management.The Shenfu group was treated with Shenfu injection at the same time as routine treatment.The gastrointestinal injury indicators(PGⅠ,PGⅡ,G17 and AGI grades)before treatment and on the 3rd and 7th days of treatment,and duration of mechanical ventilation and length of ICU stay of the two groups were recorded and compared.Results A total of 89 sepsis patients with AGI were enrolled,including 44 patients in the Shenfu group and 45 patients in the control group.Before treatment,there was no statistically significant difference in serum PGⅠ,PGⅡ,and G17 between the two groups of patients(all P>0.05).On the 3rd day of treatment,the serum PGⅠlevels in the Shenfu group were significantly lower than the control group[(156.46±62.90)µg/L vs.(183.03±45.44)µg/L,P<0.05].There was no statistically significant difference in serum PGⅡand G17 levels between the two groups(both P>0.05).On the 7th day of treatment,the serum levels of PG I,PG II,and G17 in the Shenfu group were significantly lower than those in the control group[(107.97±23.18)µg/L vs.(154.78±33.11)µg/L,(10.73±5.62)µg/L vs.(13.83±6.30)µg/L,(7.31±3.20)pmol/L vs.(9.29±3.92)pmol/L,all P<0.05].The AGI grading,duration of mechanical ventilation,and length of ICU stay in Shenfu group were significantly reduced than those in the control group(all P<0.05).Conclusion Shenfu injection can improve the serum gastric function,lower AGI grading,reduce mechanical ventilation time,and the length of ICU stay in sepsis patients with AGI.