四逆升降散对脓毒症毛细血管渗漏综合征患者凝血功能的影响

Effect of Sini Shengjiang Powder on Coagulation Function in Patients with Sepsis Capillary Leakage Syndrome

目的观察四逆升降散对脓毒症毛细血管渗漏综合征患者凝血功能的影响。方法将92例受试者随机分为对照组与治疗组各46例。在常规治疗基础上,对照组加用四逆升降散安慰剂,治疗组加用四逆升降散,治疗7d。比较两组受试者治疗前、治疗第3天、治疗第7天血栓弹力图、血小板计数(PLT)、凝血功能四项、纤维蛋白原降解产物(FDP)、D二聚体(D-Di)。结果治疗后治疗组PLT、血小板强度(MA)、血栓形成动力学(Angle)凝血综合指数(CI)、D-Di数值均下降,反应时间(R)、动力学时间(K)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)数值均上升,与对照组治疗第7天比较差异有统计学意义(P<0.05),纤维蛋白原(FIB)、FDP差异无统计学意义(P>0.05)。结论四逆升降散能够改善脓毒症毛细血管渗漏综合征患者的高凝状态,但是不会造成低凝或出血表现。

Objective:To observe the effect of Sini Shengjiang Powder on coagulation function in patients with sepsis capllary leakage syndrome.Methods:92 participants were randomly divided into a control group and a treatment group,with 46 participants in each group.On the basis of routine treatment,the control group received a placebo of Sini Shengjiang Powder,while the treatment group received the actual Sini Shengjiang Powder.The treatment lasted for 7 days.Thromboelastography(TEG),platelet count(PLT),four coagulation parameters,fibrinogen degradation products(FDP),and D-dimer(D-Di)were compared between the two groups before treatment(DO),on day 3,and on day 7 of treatment.Results:After treatment,PLT,platelet strength(MA),thrombogenesis dynamics(Angle),coagulation composite index(CI),and D-Di values decreased in the treatment group,while reaction time(R),kinetic time(K),thrombin time(TT),activated partial thromboplastin time(APTT),and prothrombin time(PT)values increased.These changes were statistically significant when compared with the control group on day 7(P<0.05).There were no statistically significant differences in fibrinogen(FIB)and FDP levels(P>0.05).Conclusion:Sini Shengjiang Powder can improve the hypercoagulable state in patients with sepsis-associated capillary leak syndrome without causing hypocoagulability or bleeding manifestations.