大承气汤加减联合血必净对腹膜炎所致脓毒症休克患者中医证候、炎症因子及临床疗效的影响

Effects of modified Dachengqi decoction combined with Xuebijing on traditional Chinese medicine symptoms,inflammatory factors and clinical efficacy in patients with septic shock caused by peritonitis

目的 观察大承气汤加减联合血必净对腹膜炎所致脓毒症休克患者中医证候、炎症因子及临床疗效的影响。方法 回顾性选取本院85例腹膜炎所致脓毒症休克患者的临床资料,根据治疗方法的不同分为大承气汤组(大承气汤加减治疗)27例、血必净组(血必净治疗)22例及联合组(大承气汤加减联合血必净治疗)36例。比较各组患者中医证候积分评分、炎症因子水平、应激指标、凝血功能指标水平及临床疗效。结果 治疗后,3组中医证候积分、炎症因子、应激指标水平较治疗前降低(P<0.05),且联合组低于大承气汤组、血必净组(P<0.05);纤维蛋白原水平较治疗前升高(P<0.05),且联合组高于大承气汤组、血必净组(P<0.05);活化部分凝血活酶时间、凝血酶原时间均较治疗前缩短(P<0.05),且联合组短于大承气汤组、血必净组(P<0.05)。联合组临床疗效的总有效率高于大承气汤组、血必净组(P<0.05)。结论 大承气汤加减联合血必净治疗能够明显降低腹膜炎致脓毒症休克患者中医证候积分,抑制炎症反应,缓解应激反应,改善凝血功能;其疗效优于大承气汤加减或血必净单独治疗效果。

Aim To explore the effects of Dachengqi decoction combined with Xuebijing on traditional Chinese medicine syndromes,inflammatory factors and clinical efficacy of septic shock patients caused by peritonitis.Methods The clinical data of 85 patients with septic shock caused by peritonitis in our hospital were retrospectively analyzed.According to different treatment methods,they were divided into Dachengqi decoction group(modified Dachengqi decoction treatment) with 27 cases,Xuebijing group(treated with Xuebijing treatment) with 22 cases,and combined group(modified Dachengqi decoction combined with Xuebijing treatment) with 36 cases.The traditional Chinese medicine syndrome score,inflammatory factor levels,stress indicators,coagulation function indicators levels,and clinical efficacy among different groups of patients were compared.Results After treatment,the traditional Chinese medicine syndrome score,inflammatory factor,and stress indicators levels in the three groups were significantly decreased compared with them before treatment(P<0.05),with lower levels in the combined group than the Dachengqi decoction group and the Xuebijing group(P<0.05).The fibrinogen level significantly was increased compared with it before treatment(P<0.05),and the combined group was higher than the Dachengqi decoction group and the Xuebijing group(P<0.05).Activated partial thromboplastin time and prothrombin time were significantly shortened compared with them before treatment(P<0.05),and the combined group was shorter than the Dachengqi decoction group and the Xuebijing group(P<0.05).The clinical efficacy of total effective rates of the combined group were higher than that of the Dachengqi decoction group and Xuebijing group(P<0.05).ConclusionThe combination of modified Dachengqi Decoction and Xuebijing can significantly reduce the traditional Chinese medicine syndrome score of septic shock patients caused by peritonitis,inhibit inflammatory reactions,alleviate stress reactions,and improve coagulation function.Its therapeutic effect is superior to that of modified Dachengqi decoction or Xuebijing treatment alone.