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[1]龍敏,張玉琴,岳煜,等.黃連解毒湯聯合西藥治療膿毒癥心肌損傷療效研究[J].陜西中醫雜志,2022,(3):329-333.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.014]
　LONG Min,ZHANG Yuqin,YUE Yu,et al.Study on clinical efficacy of Huanglian Jiedu decoction combined with western medicine on myocardial injury caused by sepsis[J].,2022,(3):329-333.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.014]
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黃連解毒湯聯合西藥治療膿毒癥心肌損傷療效研究

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《陜西中醫》雜志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期數:: 2022年3期

頁碼:: 329-333

欄目:: 臨床研究

出版日期:: 2022-03-05

文章信息/Info

Title:: Study on clinical efficacy of Huanglian Jiedu decoction combined with western medicine on myocardial injury caused by sepsis

作者:: 龍敏; 張玉琴; 岳煜; 張雨梅; 楊云華; 劉建; 孟慶娥; 王芳; 祁中蘭; (南京中醫藥大學第二附屬醫院,江蘇南京 210017)

Author(s):: LONG Min; ZHANG Yuqin; YUE Yu; ZHANG Yumei; YANG Yunhua; LIU Jian; MENG Qing'e; WANG Fang; QI Zhonglan; (The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210017,China)

關鍵詞:: 膿毒癥; 心肌損傷; 黃連解毒湯; 心功能; 心肌酶

Keywords:: Sepsis; Myocardial injury; Huanglian Jiedu decoction; Myocardial function; Myocardial enzyme

分類號:: R 542.2

DOI:: DOI:10.3969/j.issn.1000-7369.2022.03.014

文獻標志碼:: A

摘要:: 目的:探討黃連解毒湯治療膿毒血癥心肌損傷(SIMD)患者的臨床療效和預后。方法:選取68例SIMD患者,隨機為對照組(n=34)和觀察組(n=34)。對照組給予集束化等綜合治療,觀察組在對照組基礎上聯合運用黃連解毒湯。比較兩組心肌損傷指標[心肌肌鈣蛋白I(cTnI)、氨基末端腦鈉肽前體(NT-proBNP)和肌酸激酶同工酶(CK-MB)]、心功能指標[左心射血分數(LVEF)、左室舒張早期快速充盈的充盈峰和心房收縮充盈的充盈峰(E/A)、心臟每搏輸出量(SV)]、血清超氧化物歧化酶(SOD)、乳酸(Lac)、降鈣素原(PCT)水平。比較兩組應用急性生理與慢性健康狀況評分Ⅱ(APACHE Ⅱ)、序貫器官衰竭評分(SOFA)、中醫證候評分、臨床療效及預后。結果:治療后,兩組血清cTnI、NT-ProBNP、CK-MB水平均降低,且觀察組低于對照組,差異有統計學意義(均P<0.01)。治療后,LVEF、E/A、SV水平均升高,且觀察組以上指標水平高于對照組,差異有統計學意義(均P<0.01)。與治療前比較,治療后兩組血清PCT、Lac水平均降低,SOD升高,差異有統計學意義(均P<0.01)。治療后,觀察組血清PCT、Lac水平低于對照組,SOD水平高于對照組,差異有統計學意義(均P<0.01)。治療后,兩組APACHE Ⅱ、SOFA、中醫證候評分降低,觀察組以上評分均低于對照組,差異有統計學意義(均P<0.01)。觀察組總有效率高于對照組,觀察組ICU轉出率高于對照組,差異有統計學意義(均P<0.05)。結論:黃連解毒湯聯合西藥治療膿毒癥心肌損傷可提高臨床療效,減輕心肌損傷,保護心肌組織,改善預后。

Abstract:: Objective:To investigate the effect of Huanglian Jiedu decoction on clinical efficacy and prognosis of patients with sepsis-induced myocardial injury(SIMD).Methods:68 patients with SIMD were randomly divided into control group(n=34)and observation group(n=34).The control group was given cluster therapy and other comprehensive treatment.The observation group was treated with Huanglian Jiedu decoction on the basis of the control group.The cardiac injury indexes [cardiac troponin I(cTnI),amino-terminal brain natriuretic peptide precursor(NT-proBNP)and creatine kinase isoenzyme(CK-MB)],cardiac function indexes [left ventricular ejection fraction(LVEF),filling peak of early left ventricular diastolic rapid filling and filling peak of atrial contraction filling(E/A),and cardiac output per stroke(SV)],serum superoxide dismutase(SOD),lactic acid(Lac)and procalcitonin(PCT)levels were compared between the two groups.Acute physiology and chronic health status score Ⅱ(APACHE Ⅱ),sequential organ failure(SOFA)score,TCM syndrome score,clinical efficacy and prognosis were compared between the two groups.Results:After treatment,the levels of serum cTnI,NT-proBNP and CK-MB in both groups were decreased,and above indicators in the observation group were lower than the control group,difference statistically significant(all P<0.01).After treatment,the levels of LVEF,E/A and SV were increased,and above indicators in the observation group were higher than those in the control group,difference statistically significant(all P<0.01).Compared with before treatment,after treatment the levels of serum PCT and Lac were decreased,SOD increased,difference statistically significant(all P<0.01).After treatment,the levels of serum PCT and Lac in the observation group were lower than those in the control group,and SOD higher than that in the control group,difference statistically significant(all P<0.01).After treatment,the scores of APACHE Ⅱ,SOFA and TCM syndrome in both groups decreased,and above scores in the observation group were lower than those in the control group,difference statistically significant(all P<0.05).The total effective rate in the observation group was higher than that in the control group,and the ICU transfer rate in the observation group higher than that in the control group,difference statistically significant(all P<0.01).Conclusion:Huanglian Jiedu decoction can improve clinical efficacy,alleviate myocardial injury,protect myocardial tissue and improve prognosis in the treatment of septic myocardial injury.

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備注/Memo

備注/Memo:: 基金項目:江蘇省中醫藥管理局科研項目(YB2020026); 江蘇省第二中醫院院內課題(SEZ202123)

更新日期/Last Update: 2022-03-09

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