参麦注射液联合氢化可的松治疗老年脓毒性休克的临床研究

Clinical study on Shenmai Injection combined with hydrocortisone in treatment of senile septic shock

目的探索参麦注射液联合氢化可的松对老年脓毒性休克的治疗效果。方法选取2015年7月—2018年7月沧州市人民医院收治的脓毒性休克患者102例,随机分为对照组(51例)和治疗组(51例)。对照组静脉滴注注射用氢化可的松琥珀酸钠,200 mg加入生理盐水250 mL,1次/d;治疗组在对照组基础上静脉滴注参麦注射液,100 mL/次,1次/d。两组患者均持续治疗5天。观察两组患者临床疗效,同时比较治疗前后两组患者白细胞计数、APACHEⅡ评分、乳酸、降钙素原和脑钠肽水平及随访结果。结果治疗后,对照组和治疗组临床有效率分别为76.47%和86.27%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者白细胞计数、C-反应蛋白水平及APACHEⅡ评分均明显降低(P<0.05),且治疗组白细胞计数、C-反应蛋白水平及APACHEⅡ评分明显低于对照组(P<0.05)。治疗后,两组患者乳酸、降钙素原和脑钠肽水平均显著降低(P<0.05),且治疗组乳酸、降钙素原和脑钠肽水平明显低于对照组(P<0.05)。治疗组ICU住院时间、14 d死亡率及28 d死亡率上均优于对照组,两组比较差异具有统计学意义(P<0.05)。结论参麦注射液联合氢化可的松可明显改善老年脓毒性休克患者早期生理生化指标,提高整体生存率。

Objective To explore the therapeutic effect of Shenmai Injection combined with hydrocortisone in treatment of senile septic shock.Methods Patients(102 cases)with senile septic shock in Cangzhou People’s Hospital from July 2015 to July 2018 were randomly divided into control(51 cases)and treatment(51 cases)groups.Patients in the control group were iv administered with Hydrocortisone Sodium Succinate for injection,200 mg added into normal saline 250 mL,once daily.Patients in the treatment group were iv administered with Shenmai Injection on the basis of the control group,100 mL/time,once daily.Patients in two groups were treated for 5 d.After treatment,the clinical efficacy was evaluated,and the WBC and APACHEⅡscores,levels of lactic acid,procalcitonin and brain natriuretic peptide,follow-up results in two groups before and after treatment were compared.Results After treatment,the clinical efficacy and in the control and treatment groups was 76.47%and 86.27%respectively,and there were differences between two groups(P<0.05).After treatment,the WBC,CRP levels and APACHEⅡscores in two groups were significantly decreased(P<0.05),and these indexes in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the levels of lactic acid,procalcitonin and brain natriuretic peptide in two groups were significantly decreased(P<0.05),and which in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the hospitalization time in ICU,mortality rate of 14 d and 28 d in two groups was significantly less than those in the control group(P<0.05).Conclusion Shenmai Injection combined with hydrocortisone in treatment of senile septic shock can obviously improve early physiological and biochemical indexes and improve overall survival rate.