[1]龙 敏,张玉琴,岳 煜,等.黄连解毒汤联合西药治疗脓毒症心肌损伤疗效研究[J].陕西中医,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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黄连解毒汤联合西药治疗脓毒症心肌损伤疗效研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年3期
页码:
329-333
栏目:
临床研究
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:
龙 敏; 张玉琴; 岳 煜; 张雨梅; 杨云华; 刘 建; 孟庆娥; 王 芳; 祁中兰
(南京中医药大学第二附属医院,江苏 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)
关键词:
脓毒症;  心肌损伤;  黄连解毒汤;  心功能;  心肌酶
Keywords:
Sepsis;  Myocardial injury;  Huanglian Jiedu decoction;  Myocardial function;  Myocardial enzyme
分类号:
R 542.2
DOI:
DOI:10.3969/j.issn.1000-7369.2022.03.014
文献标志码:
A
摘要:
目的:探讨黄连解毒汤治疗脓毒血症心肌损伤(SIMD)患者的临床疗效和预后。方法:选取68例SIMD患者,随机为对照组(n=34)和观察组(n=34)。对照组给予集束化等综合治疗,观察组在对照组基础上联合运用黄连解毒汤。比较两组心肌损伤指标[心肌肌钙蛋白I(cTnI)、氨基末端脑钠肽前体(NT-proBNP)和肌酸激酶同工酶(CK-MB)]、心功能指标[左心射血分数(LVEF)、左室舒张早期快速充盈的充盈峰和心房收缩充盈的充盈峰(E/A)、心脏每搏输出量(SV)]、血清超氧化物歧化酶(SOD)、乳酸(Lac)、降钙素原(PCT)水平。比较两组应用急性生理与慢性健康状况评分Ⅱ(APACHE Ⅱ)、序贯器官衰竭评分(SOFA)、中医证候评分、临床疗效及预后。结果:治疗后,两组血清cTnI、NT-ProBNP、CK-MB水平均降低,且观察组低于对照组,差异有统计学意义(均P<0.01)。治疗后,LVEF、E/A、SV水平均升高,且观察组以上指标水平高于对照组,差异有统计学意义(均P<0.01)。与治疗前比较,治疗后两组血清PCT、Lac水平均降低,SOD升高,差异有统计学意义(均P<0.01)。治疗后,观察组血清PCT、Lac水平低于对照组,SOD水平高于对照组,差异有统计学意义(均P<0.01)。治疗后,两组APACHE Ⅱ、SOFA、中医证候评分降低,观察组以上评分均低于对照组,差异有统计学意义(均P<0.01)。观察组总有效率高于对照组,观察组ICU转出率高于对照组,差异有统计学意义(均P<0.05)。结论:黄连解毒汤联合西药治疗脓毒症心肌损伤可提高临床疗效,减轻心肌损伤,保护心肌组织,改善预后。
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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备注/Memo

备注/Memo:
基金项目:江苏省中医药管理局科研项目(YB2020026); 江苏省第二中医院院内课题(SEZ202123)
更新日期/Last Update: 2022-03-09