Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury

AIM： To investigate the effect of shenfu injection on gastrointestinal microcirculation after myocardial ischemic-reperfusion （IR） injury in rabbits and probe into the mechanism. METHODS： Forty healthy flap-eared white rabbits were randomly divided into 4 groups： IR injury control group （group Ⅰ ）, shenfu injection 5 mL/kg per h group （group Ⅱ）, shenfu injection 10 mL/kg per h group （group Ⅲ） and shenfu injection 20 mL/kg per h group （group Ⅳ）. The four groups were treated with Lactated Ringer＇s solution, shenfu injection 5, 10, and 20 mL/ kg per h were infused intravenously 30 min before experiment respectively. The values of hemodynamics [mean arterial pressure （MAP）, heart rate （HR）, gastric intramucosal partial pressure of carbon dioxide （PCO2）, blood gas analysis and pH] were measured and compared with those before myocardial ischemia, 60 min after myocardial ischemia and 60, 90, and 180 rain after reperfusion. RESULTS： The MAP, HR and gastric intramucosal pH were （70.50 ± 4.50） kPa, （165 ± 14） beats per rain, 7.032 ± 0.024 in group Ⅰ 60 min after myocardial ischemia, which were significantly decreased compared with those before myocardial ischemia （88.50 ± 9.75 kPa, 217 ± 18 beats per rain, 7.112 ± 0.035, P 〈 0.05）. The MAP, HR and gastric intramucosal pH were significantly decreased in group Ⅰ 60, 90, and 180 min after reperfusion （61.50 ± 5.25 kPa, 133 ± 31 beats per rain, 6.997 ± 0.025） compared with those before reperfusion respectively （P 〈 0.05）, whereas the values were insignificantly different in groups Ⅱ, Ⅲ or Ⅳ after reperfusion, compared with those before reperfusion, and there were no significant differences between groups Ⅱ, Ⅲ, and Ⅳ after reperfusion. CONCLUSION： Pre-infusion of shenfu injection has a protective effect on gastrointestinal microcirculation after myocardial IR injury in rabbits, in a dose independent manner.

Improvement of Quality of Life with Shenfu Injection (参附注射液) in Non Small Cell Lung Cancer Patients Treated with Gemcitabine plus Cisplatin Regimen

Objective： To observe the effect of Shenfu injection （参附注射液, SFI） in treating non small cell lung cancer （NSCLC） patients on quality of life with gemcitabine （GEM） plus cisplatin （GP） regimen. Methods： Thirty-four patients were ready to receive GP regimen chemotherapy for treating NSCLC disease, according to lot-drawing, they were divided into SFI pre-treatment group （18 cases） and SFI post-treatment group （ 16 cases）. SFI pre-treatment group： During the first treatment course, chemotherapy was begun with SFI 60 ml, intravenous dripping on the 3rd day, once daily, consecutively for 10 days; on the 1st day, GP regimen （GEM 1250 mg/m^2 , intravenous dripping, on the 1st and 8th day; cisplatin 70 mg/m^2 on the 2nd day; 21 days as one cycle） was carried out; in the second treatment course GP regimen was merely given to serve as the self-control. SFI post-treatment group： the medicament sequence order was reversed from that of pre-treatment group. Using dual international quality of life （QOL） scores, the effect of SFI on the patients＂ QOL was observed through randomized self pre- and post- crossover control. Results： The QOL in the 34 patients after being treated by SFI in combination with GP chemotherapy regimen in one group, and GP chemotherapy regimen alone in the other, was improved in different degrees, with significant difference （P〈0.01）; comparision of SFI combined with GP chemotherapy regimen with GP chemotherapy alone showed that QOL in patients was significantly different （P〈0.01）. Conclusion： SFI could improve QOL in patients with NSCLC who were treated with GP regimen.

Effect of Shenfu injection on ischemia-reperfusion injury of rat liver graft

BACKGROUND: It is reported that Shenfu injection (an injection prepared from traditional Chinese medicines red ginseng and aconite root) can decrease the extent of ischemia-reperfusion injury to many organs, such as the heart and kidney. We therefore investigated the effect of Shenfu injection on ischemia-reperfusion injury of rat liver graft and its mechanism. METHODS: Male Sprague Dawley (SD) rats were used as a model for isogeneic orthotopic liver transplantation. Sixty rats were randomly devided into two groups (30 in each group). The recipient was given intravenous Shenfu injection immediately before the removal of the liver in the Shenfu group and normal saline of the same volume in the control group. At 3, 6 and 24 hours after the reperfusion, blood and hepatic tissue were taken for examination. RESULTS: The levels of superoxide dismutase (SOD) and nitric oxide (NO) increased more significantly in the Shenfu group than in the control group (P <0.05). The levels of serum liver enzymes, hyaluronic acid (HA), malondialde-hyde (MDA), tumor necrosis factor-alpha(TNF-α), inter-leukin-1 (IL-1), endothelin -1 (ET-1) and liver cell apopto-sis index were lower in the Shenfu group than in the control group (P <0. 05). Microscopic examination revealed that the morphological changes of hepatic tissue were more severe in the control group than in the Shenfu group. CONCLUSIONS: Shenfu injection has protective effect on ischemia-reperfusion injury of rat liver graft. It inhibits the production of oxygen free radical and the activation of Kupffer cells, decreases apoptosis of liver cell, and improves microcirculation.

Effect of Shenfu injection on microcirculation effect index in early-and middle-stage of cardiogenic shock rats

OBJECTIVE Shenfu injection(SFI)is an effective treatment of cardiogenic shock,the pathology of the central link was microcirculation disturbance.However,whether the microcirculation status of the early-and mid-stage of cardiogenic shock has any difference is unclear.This study aimed to observe the effect of SFI on the microcirculatory disturbance in mesentery for early-and mid-stage of cardiogenic shock rat.METHODS The early-and mid-stage model of cardiogenic shock was established by ligating the ending or root of left anterior descending coronary arteries(LADCA).The rats were randomly divided into 9 groups,ie control group,early-stage model group,mid-stage model group,3 early medicated groups and 3 mid medicated groups(the dosage was 1,3.33,10 mL·kg^(-1) SFI for cardiogenic shock rats of early-and mid-stage,respectively).Parameters in mesenteric microcirculation,such as velocity of RBCs in venules,diameters of venules,the count of leukocyte adhesion and vascular permeability which calculated by FITC-dextran leakage were observed through an GeneandiM2 inverted intravital microscope and high-speed video camera system.RESULTS The cardiogenic shock induced by ligating the LADCA resulted in a number of responses in microcirculation,including a significant increase in the counts of adhesive leukocytes,narrowing of the vascular diameter,decrease in the velocity of RBCs and dextran efflux.All of the above parameters for early-stage cardiogenic shock rats were attenuated by the treatment with SFI,especially the dosage of 10 mL·kg^(-1).While SFI had no apparent time-effect on the vascular diameter and vascular permeability in mesentery for mid-stage cardiogenic shock rats.CONCLUSION The microcirculation status of the early-and mid-stage of cardiogenic shock rats were quite different.The efficacy of early treatment with SFI was more obvious than the mid administration,which could provide experimental and theoretical basis for the patients with cardiogenic shock in an earlier time.

Shenfu injection plus vinorelbine for elderly patients with non-small cell lung cancer in promoting the quality of life: a randomized controlled clinical trial

Objective： The present study aimed to investigate the efficacy of Shenfu injection plus vinorelbine on the promotion of the quality of life （QOL） in elderly non-small cell lung cancer （NSCLC） patients. Methods： A randomized single blind trial method was used. Forty-six patients with stage IIIB-IV of HSCLC were randomly divided into experimental group and control group. In the experimental group, the patients were treated with 50 mL Shenfu injection from day 1 to 14, plus vinorelbine （NVB） 25 mg/m^2 on day 1 and 8. In the control group, the patients were only treated with NVB 25 mg/m^2 on day 1 and 8. After two cycle＇s of treatment, QOL, efficacy and toxicity were observed. Results： The QOL was enhanced in both experimental group and control group. However, the difference of KPS after treatment in the experimental group was markedly higher than in the control group （14 ± 10 vs. 8 ± 10, t = 2.116, P = 0.04）, improvement rate of QOL was better than in the control group （76.2% vs. 45.0%, χ^2 = 4.188, P = 0.041）, treatment related toxicity in the experimental group was also markedly lower than in the control group （χ^2 = 3.866, P = 0.049）, but the difference of efficacy between the two groups was not significant （14.3% vs. 15.0%, χ^2 = 0.161, P = 0.688）. Conclusion： Shenfu injection plus vinorelbine can enhance QOL in elderly NSCLC patients.

Therapeutic Effect of Shenfu Injection (参附注射液) on Secondary Aplastic Anemia of Tumor Patients after Chemotherapy

Objective: To explore the effect of Shenfu Injection (参府注射液, SFI) on the secondary aplastic anemia (AA) of tumor patients after chemotherapy (CT). Methods: The 15 cases of SFI treated group, 10 cases of control group, 25 cases of SFI + granulocyte-macrophage colony stimulating factor (GM-CSF) treated group and the group of 23 GM-CSF-treated tumor cases of secondary AA after CT were compared, with their increasing rate and the rebound speed of neutrophil, platelet, bone marrow nucleated RBC, granulocyte, and megakaryocyte all being investigated. Results: The increasing rate and rebound speed of granulocyte, platelet, and the increasing rate of bone marrow nucleated RBC, granulocyte, megakaryocyte were obviously higher than those of the control, and the clinical manifestations were also obviously improved. The increasing rate of platelet, bone marrow nucleated RBC, megakaryocyte of the SFI + GM-CSF group were higher than those of the group which used GM-CSF alone, while the increasing rate of granulocyte in blood and bone marrow in both groups was similar. Conclusion: Significant efficacy was shown in SFI for the treatment of secondary AA of tumor patients after CT.

Protective Effect of Shenfu Injection on Rats with Chronic Heart Failure Induced by Doxorubicin

[Objectives] To determine the protective effect of Shenfu injection( SFI) on chronic heart failure( CHF) in rats induced by doxorubicin. [Methods] CHF was induced by doxorubicin via intraperitoneal injection in rats. The cardiac function parameters,the heart index,the serum brain natriuretic peptide( BNP) level and cardiac histopathology were measured 4 weeks after Shenfu injection treatment. [Results]Shenfu injection remarkably improved the heart index and cardiac histopathology,increased the heart rate( HR),left ventricular systolic pressure( LVSP),maximum rising rate of left ventricular pressure( + dp/dtmax) and dropping rate of left ventricular pressure(-dp/dtmax),reduced the left ventricular end-diastolic pressure( LVEDP) and serum BNP level of rats with CHF induced by doxorubicin. [Conclusions]Shenfu injection exerts protective effect on CHF induced by doxorubicin.

Exploration on the Effect and Mechanism of Shenfu Injection (参附注射液) on Resuscitation from General Anesthesia

Objective: To investigate the effect and the mechanism of Shenfu injection (SFI, ) on the resuscitation from general anesthesia . Methods: Forty patients who received selective abdominal surgery with general anesthesia for 3-4 hrs and ASA grade Ⅰ-Ⅱ were divided into two groups, the trial group and the control group, 20 patients in each group. After being sent into the postanesthesia care unit (PACU), the trial group was treated with intravenous dripping of SFI 1.0 ml/kg and the control group was treated with intravenous dripping of equal volume of normal saline. All patients were observed in double blindly manner, the self ventilation recovery time, extubation time, the time of leaving PACU and their Glasgow coma scale (GCS) were recorded and compared. 2 ml of peripheral venous blood were taken to determine the plasma β-endorphin (β-EP) content at the time points of before (T1), 5min (T2), 15min (T3) and 30 min (T4) after dripping. Results: The self ventilation recovery time, extubation time and time of leaving PACU in the trial group were all shorter than those in the control group (P<0 01), the GCS in the trial group was better than that in the control group (P<0 01). The plasma content of β-EP raised gradually along the recovering of patients consciousness, as compared with the content before dripping (T1), it showed insignificant difference at time point T2 but significant difference at T3 and T4, comparison at the corres ponding time point showed that the content at T1 and T2 were similar in the two groups (P>0 05), but at T3 and T4, the content was higher in the trial group than that in the control group respectively (P<0 01). There was insignificant difference between T1 and before treatment ( P>0 05), but significant difference was found when compared T3, T4 and before treatment (P<0 01).Conclusion: SFI could accelerate the resuscitation after general anesthesia, the mechanism may be related with its action in raising plasma β-EP level.

Systematic Evaluation and Meta-Analysis of the Efficacy and Safety of Shenfu Injection in the Treatment of Septic Cardiomyopathy

Objective:To evaluate the efficacy and safety of Shenfu injection in the treatment of septic cardiomyopathy.Methods:Literatures on Shenfu injection for the treatment of sepsis published from the establishment of each database to December 31,2020,were searched by computer;Cochrane risk-of-bias tool was used for evaluating the quality of literatures,and Review Manager 5.4 software was used for meta-analysis.Results:Twenty random controlled trials(RCTs)were included,with a total of 1,179 patients;the meta-analysis showed that the routine treatment of Western medicine combined with Shenfu injection can reduce the 28-day mortality,the length of hospital stay,cardiac troponin I(cTnI),and N-terminal pro-brain natriuretic peptide(NT-proBNP)as well as improve the left ventricular ejection fraction(LVEF)with low incidence of adverse reactions.Conclusion:Western medicine combined with Shenfu injection can further reduce myocardial injury in patients with sepsis and improve cardiac function as well as the prognosis of patients with septic cardiomyopathy.

Meta-analysis of the Effect of Shenfu Injection on Immune Function in Patients with Sepsis

Objective:To systematically evaluate the effects of Shenfu Injection on immune function of sepsis patients by meta-analysis.Methods:The randomized controlled trials of Shenfu Injection in the treatment of sepsis published from 2000 to February 2021 were searched in CNKI,WanFang database and VIP database.The control group was treated with routine treatment;The experimental group was treated with Shenfu Injection on the basis of routine treatment.The included literature was evaluated by Cochrane bias risk evaluation table,and Shenfu Injection was used to treat patients with sepsis with RevMan 5.3 software.The results of meta-analysis were as reported.Conclusion:However,due to the limitation of the quality and quantity of the included research,multi center,large sample volume and high-quality RCT are still needed to verify the research results.

Effectiveness and safety of Shenfu injection in septic patients with hypoperfusion:A multi-center,open-label,randomized,controlled trial

Background:To evaluate the effectiveness and safety of the Shenfu injection(SFI)combined with standard bundle treatment in septic patients with hypoperfusion.Method:This study was a multi-center,randomized,open-label,controlled trial conducted in four teaching hos-pitals in China.The septic patients with hypoperfusion and traditional Chinese medicine(TCM)syndrome with Yang-Qi deficiency were enrolled from January 2019,through September 2020.Eligible patients were randomly allocated in a 1:1 ratio to either receive 60 mL of SFI infusion per day plus standard treatment(SFI group)or stan-dard bundle treatment alone(control group).The primary outcome was 28-day all-cause mortality.Secondary outcomes were 90-day all-cause mortality time to weaning from mechanical ventilation,time to weaning from vasopressors,time to discharge from the ICU and hospital,and laboratory results after randomization.Results:A total of 188 patients completed the trail.This study revealed that the results of the SFI group and the control groups were not statistically significant in 28-day all-cause mortality(10.6%vs.20.2%,respectively;P=0.106).The infusion of SFI was associated with a significant reduction in the duration of vasopressor use(median=4.0 days,interquartile range[IQR]:2.0 days-6.0 days vs.median=5.0 days,IQR:3.0 days-8.0 days,respectively;P=0.043).Patients in the SFI group had statistically greater reductions in plasma lactate levels compared with those in the control group at the first 12 h(median=1.1 mmol/L,IQR:0.3-2.0 mmol/L vs.median=0.0 mmol/L,IQR:−0.2 to 0.8 mmol/L,respectively;P<0.001)and 24 h(median=1.4 mmol/L,IQR:0.3-2.2 mmol/L vs.median=0.4 mmol/L,IQR:−0.4 to 1.6 mmol/L,respectively;P=0.001).Conclusion:SFI plus standard therapy did not significantly decrease 28-day all-cause mortality for septic patients with hypoperfusion and TCM syndrome with Yang-Qi deficiency.

参附注射液对急性心衰患者炎性指标、心功能及临床疗效的影响

目的观察参附注射液对急性心力衰竭(心肾阳虚型)患者的疗效,并探讨其作用机制。方法89例患者按随机数字表法分为观察组45例与对照组44例,两组均给予常规西药治疗,观察组在对照组基础上加用参附注射液。比较两组血清炎性指标、血流动力学指标、心功能及临床疗效。结果两组治疗前白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、左心室射血分数(LVEF)、脑利钠肽(BNP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)水平和血流动力学指标心排血量(CO)、平均动脉压(MAP)、肺动脉压(PAP)水平比较,差异无统计学意义(均P>0.05)。两组治疗后5、10 d,IL-6、hs-CRP、LVEF、BNP、CK-MB、cTnT水平和血流动力学指标CO、MAP、PAP水平均较治疗前改善(均P<0.05),且观察组的各项指标改善均优于对照组(P<0.05)。治疗后观察组的总有效率为86.67%,高于对照组的72.73%。两组治疗期间及治疗后均未发现不良反应。结论参附注射液治疗急性心力衰竭可有效降低患者的血清炎性指标,改善血流动力学,提高心功能,改善生活质量,疗效良好。

参附注射液治疗心肾阳虚型慢性心力衰竭急性加重的临床研究

目的:观察参附注射液治疗心肾阳虚型慢性心力衰竭急性加重的临床疗效。方法:选取2023年10月—2024年1月在安徽中医药大学第一附属医院住院的慢性心力衰竭急性加重病人60例,按照随机数字表法分为观察组与对照组,各30例。观察组给予参附注射液加西医常规治疗,对照组仅给予西医常规治疗,比较两组治疗前后血浆氨基末端B型钠尿肽前体(NT-proBNP)、超敏肌钙蛋白I(hs-cTnI)、6 min步行试验(6MWT)、明尼苏达州心力衰竭生活质量问卷评分(MLHFQ)、中医证候积分及纽约心脏病协会(NYHA)心功能分级。结果:与治疗前比较,两组治疗后NT-proBNP、hs-cTnI水平降低(P<0.05),两组治疗后NT-proBNP、hs-cTnI水平比较差异均无统计学意义(P>0.05);与治疗前比较,两组治疗后6MWT、MLHFQ评分均明显改善(P<0.05),观察组改善程度优于对照组(P<0.05);两组治疗后各单项中医证候积分低于治疗前(P<0.05),观察组治疗后喘促气短、倦怠乏力、畏寒肢冷及言语声低评分低于对照组(P<0.05)。观察组总有效率为96.7%,对照组为80.0%,两组比较差异有统计学意义(P<0.05)。结论:参附注射液联合西药常规治疗可改善心肾阳虚型慢性心力衰竭急性加重病人心功能,提高病人运动耐量和生活质量。

参附注射液治疗心脏骤停后脑复苏的研究进展

心脏骤停是由多种因素引起的心脏停止泵血,导致患者出现意识丧失、循环衰竭、呼吸心跳停止的临床急危症,具有极高的病死率。脑复苏的程度是判断心肺复苏术成功的关键环节之一,对于评估患者的预后具有重要的价值。参附注射液是治疗心脏骤停后脑复苏的有效方法之一,已在临床急救中广泛应用。本文通过分析心脏骤停后脑复苏的发病机制,总结多靶点之参附注射液在临床及实验方面的研究,以期为机制学研究提供新思路。

基于miR-139/Wnt/β-catenin信号通路探讨参附注射液对慢性心力衰竭大鼠心肌纤维化的保护作用

目的探讨参附注射液对盐酸异丙肾上腺素(isoprenaline hydrochloride,ISO)诱导的慢性心力衰竭(chronic heart failure,CHF)大鼠心肌纤维化的作用与机制。方法采用随机数字表法将45只SD大鼠随机分为正常组9只,造模组36只,采用ISO背部皮下多点注射14天制备CHF大鼠模型,再正常饲养14 d通过模型验证和评价,期间死亡大鼠5只,未成模大鼠4只。将造模成功的27只大鼠按随机数字表法分为3组:模型组(腹腔注射6 mL·kg^(-1)氯化钠注射液+灌胃10 mL·kg^(-1)蒸馏水)、参附注射液组(腹腔注射6 mL·kg^(-1)参附注射液+灌胃10 mL·kg^(-1)蒸馏水)、卡托普利组(腹腔注射6 mL·kg^(-1)生理盐水+灌胃10 mL·kg^(-1)蒸馏水,蒸馏水含8.8 mg·kg^(-1)卡托普利,相当于临床等效量)。药物干预15 d后,检测各组大鼠心功能及心肌纤维化的相关指标:超声心动图、体质量、心脏质量指数及左心室质量指数;ELISA法检测氨基末端脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP);HE染色、Masson染色检测心肌组织病理形态及纤维化状态;RT-qPCR检测心肌组织中miR-139、Wnt家族成员3a(Wnt family member 3a,Wnt3a)、β-连环蛋白(β-catenin)、糖原合成酶激酶3β(glycogen synthase kinase 3β,GSK3β)、Ⅰ型胶原蛋白(typeⅠcollagen,Col-Ⅰ)、Ⅲ型胶原蛋白(typeⅢcollagen,Col-Ⅲ)及α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)、基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)mRNA的表达;Western blot检测心肌组织中Wnt3a、β-catenin、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA、MMP-2、MMP-9蛋白表达。结果与正常组比较,模型组左室射血分数(left ventricular ejection fraction,LVEF)、左室短轴缩短率(left ventricular fraction shortening,LVFS)、体质量降低(P<0.01),左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、NT-proBNP、心脏质量指数、左心室质量指数升高(P<0.01),miR-139表达量下降(P<0.01),Wnt3a、β-catenin、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA、MMP-2、MMP-9蛋白和mRNA表达升高(P<0.01);细胞排列紊乱,心肌纤维化明显,伴有明显的炎症浸润。与模型组比较,参附注射液组LVEF、LVFS、体质量升高(P<0.01或P<0.05),LVEDD、LVESD、NT-proBNP、心脏质量指数、左心室质量指数降低(P<0.01),miR-139表达量升高(P<0.01),Wnt3a、β-catenin、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA、MMP-2、MMP-9蛋白和mRNA表达降低(P<0.01);细胞排列趋于整齐,纤维结缔组织增生及炎症细胞浸润现象减少,胶原纤维沉积减少,纤维化程度减轻。结论参附注射液能改善CHF大鼠心功能及心肌纤维化状态,其机制可能与调控miR-139/Wnt/β-catenin信号通路有关。

参附注射液联合血必净注射液对脓毒症心肌病患者循环和毛细血管充盈时间的影响

目的 评价参附注射液加血必净注射液对(脓毒症心肌病SIC)患者循环和毛细血管充盈时间的影响。方法 将87例SIC患者随机分为治疗组和对照组,对照组44例,治疗组43例。对照组患者给予脓毒症集束化治疗;治疗组在对照组的基础上给予血必净注射液加参附注射液静脉滴注,两组疗程均为3 d。评估病情和预后指标(APACHEⅡ评分、SOFA评分)、心肌损伤标志物(cTnT、NT-ProBNP)、血流动力学指标(MAP、CVP、CI)、微循环指标(Lac、24 h Lac清除率、CRT)。结果 治疗后,两组APACHEⅡ评分、SOFA评分、cTnT、NT-ProBNP、Lac、CRT均降低(P<0.05),均以治疗组更明显(P<0.05),24 h Lac清除率治疗组高于对照组(P<0.05)。治疗后两组患者MAP、CVP较治疗前均升高,治疗后24、48、72 h,治疗组CI高于照组;治疗后第6、24 h,治疗组患者Lac低于对照组(P<0.05);治疗后第3、6、24 h,治疗组患者CRT低于对照组(P<0.05)。结论 在西医常规集束化治疗的基础上,加用参附注射液和血必净注射液治疗,可改善微循环及血流动力学,抑制心肌损伤,有利于改善SIC患者的心功能。

参附注射液联合乌司他丁辅助治疗脓毒症休克的临床研究及预后分析

目的 探讨参附注射液联合乌司他丁辅助治疗脓毒症休克的临床效果。方法 选取2022年1月至2023年6月于邯郸市中心医院就诊的91例脓毒症休克患者为研究对象,根据随机数字表法将其分为治疗组(47例)和对照组(44例)。两组患者均给予常规治疗,对照组给予乌司他丁注射液治疗,治疗组给予参附注射液联合乌司他丁注射液治疗。比较两组患者治疗前和治疗1d、3d、7d的超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、一氧化氮(nitric oxide,NO)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及两组患者入住急诊重症监护室(emergency intensive care unit,EICU)时间和28d死亡率。结果 治疗组患者入住EICU时间显著短于对照组,28d死亡率显著低于对照组(P<0.05)。治疗1d、3d、7d,两组患者的血清TNF-α、IL-6、MDA、NO水平均显著低于本组治疗前,治疗组患者的SOD水平均显著高于治疗前,对照组患者的SOD水平先下降后升高(P<0.05);治疗组患者的血清TNF-α、IL-6、MDA、NO水平均显著低于对照组,SOD水平显著高于对照组(P<0.05)。结论 在常规治疗的基础上,应用参附注射液联合乌司他丁治疗可进一步抑制炎症因子释放,减轻氧化应激水平,缩短患者入住EICU时间,降低28d死亡率,为脓毒症休克治疗提供新的思路。

参附注射液联合西医疗法治疗急性心力衰竭的疗效观察

目的观察参附注射液联合西医疗法治疗急性心力衰竭(AHF)的疗效。方法94例AHF患者随机分为观察组与对照组各47例。对照组应用西医疗法,观察组应用参附注射液联合西医疗法。对比两组疗效、比较氨基末端脑利钠肽前体(NT-proBNP)、乳酸(Lac)、左室射血分数(LVEF)、心率(HR)、呼吸频率(R)、血氧饱和度(SaO_(2))值。结果观察组的总有效率为89.36%,高于对照组的72.34%(P<0.05)。治疗后两组NTproBNP、Lac值降低,且观察组NT-proBNP、Lac值低于对照组(P<0.05);两组LVEF值增加,且观察组LVEF值高于对照组(P<0.05);两组HR、R值降低,SaO_(2)值增加,但组间HR、R、SaO_(2)值差异无统计学意义(P<0.05)。结论参附注射液联合西医疗法治疗AHF,能显著促进心功能及病情恢复,疗效好。

参附注射液对失血性休克大鼠肺损伤的影响

目的观察参附注射液对大鼠失血性休克(HS)致肺损伤的影响并探讨潜在机制。方法选择SPF级健康雄性SD大鼠36只,16~17周龄,体重400~600 g。采用随机数字表法将大鼠分为三组:假手术组(SH组)、失血性休克组(HS组)和参附注射液组(SF组),每组12只。SH组麻醉后仅分离出右股静脉和股动脉,不行动静脉置管,HS组和SF组制备HS大鼠模型。HS组经静脉导管进行液体复苏,复苏液为所失自体血加1.5倍失血量的复方氯化钠注射液与生理盐水10 ml/kg,SF组复苏液为所失自体血加1.5倍失血量的复方氯化钠注射液与参附注射液10 ml/kg,灌注时间约60 min。于术后24、48 h随机处死6只大鼠,取肺组织检测湿重与干重比(W/D),采用ELISA法检测白细胞介素-6(IL-6)、IL-17、IL-10、转化生长因子-β(TGF-β)浓度,采用PCR法检测肺组织视黄酸相关孤核受体γt(RORγt)、叉头翼状螺旋转录因子3(Foxp3)、缺氧诱导因子1α(HIF-1α)mRNA表达量,采用Western blot法检测RORγt、Foxp3、HIF-1α、水通道蛋白1(AQP1)和AQP5蛋白含量,肺组织行HE染色后在光镜下观察病理学改变并行肺损伤评分。结果与术后24 h比较,术后48 h SF组肺组织W/D、IL-6和IL-17浓度、RORγt和HIF-1αmRNA表达量及蛋白含量、肺损伤评分均明显降低(P<0.05),IL-10和TGF-β浓度、Foxp3 mRNA表达量及蛋白含量、AQP1蛋白含量均明显升高(P<0.05)。与SH组比较,术后24、48 h HS组和SF组W/D、IL-6、IL-17、IL-10和TGF-β浓度、RORγt、Foxp3和HIF-1αmRNA表达量及蛋白含量、肺损伤评分均明显升高(P<0.05),AQP1、AQP5蛋白含量明显降低(P<0.05),光镜下可见肺泡结构破坏,肺泡间质充满大量水肿液,其间浸润着大量炎性细胞。与HS组比较,术后24、48 h SF组W/D、IL-6和IL-17浓度、RORγt和HIF-1αmRNA表达量及蛋白含量、肺损伤评分明显降低(P<0.05),IL-10和TGF-β浓度、Foxp3 mRNA表达量及蛋白含量、AQP1和AQP5蛋白含量均明显升高(P<0.05),光镜下可见肺泡结构紊乱改善,水肿程度减轻,炎性细胞数量减少。结论参附注射液可调节促炎因子IL-6、IL-17与抗炎因子IL-10、TGF-β平衡,升高肺组织AQP1、AQP5蛋白含量,降低肺组织W/D和肺损伤评分,减轻HS大鼠肺损伤,机制可能与调节HIF-1α-RORγt/Foxp3平衡有关。

参附注射液联合针刺外治法治疗感染性休克的临床观察

[目的]观察参附注射液联合针刺外治法对感染性休克患者的影响。[方法]将筛选出的感染性休克患者66例随机分为对照组和观察组,各33例,两组均予以常规西医综合治疗,观察组联合应用参附注射液及针刺外治法,两组均连续治疗7天。比较两组患者治疗前后炎性损伤指标、氧代谢指标(氧合指数、中心静脉血氧饱和度、静-动脉二氧化碳分压差、血乳酸)变化;比较两组血管活性药物使用时间、早期目标指导性复苏治疗(EGDT)达标时间及28 d病死率。[结果]治疗后观察组的降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、血乳酸水平及静-动脉二氧化碳分压差均低于对照组,差异有统计学意义(P<0.05);观察组氧合指数、中心静脉血氧饱和度均高于对照组,差异有统计学意义(P<0.05);治疗后两组白细胞介素-1(IL-1)水平差异无统计学意义(P>0.05);治疗后观察组血管活性药物使用时间、早期目标指导性复苏治疗(EGDT)达标时间及28 d病死率均低于对照组,差异有统计学意义(P<0.05)。[结论]在感染性休克早期治疗中应用参附注射液联合针刺外治法可以有效降低炎症反应,改善组织缺氧,缩短血管活性药物使用时间,降低病死率。