清热通腑法治疗脓毒症的临床视察.pdfVIP

提 要 目的：评价清热通腑法辅助治疗脓毒症毒热内盛证临床疗效并初步探讨其作用机 理，以进行探索关于中西医结合治疗的脓毒症新途径。 方法：选择2011年4月－2012年4月收治于山东省中医院急诊科、ICU病房的 60例脓毒症毒热内盛证或瘀毒内阻证患者，随机分为治疗组（30例，采用西医常规 治疗+五味消毒饮合小承气汤加减组方中药），对照组（30例，采用西医常规治疗）， 以进行前瞻性对照研究。分别于入选时及疗程结束时进行一般生命体征检查、APACHE Ⅱ评分、抽取静脉血测定观察指标，用以观察治疗前后各项指标的变化情况。采用 SPSS 17.0软件进行统计分析。 结果：经治疗7天后，治疗组与对照组比较存在限制性差异（P＜0.05）。同时， APACHEⅡ积分、体温（T）、心率（P）、呼吸频率（R）、白细胞总数（WBC）、中性粒细 胞总数（NEU）、中性粒细胞百分比（NEU%）、C反应蛋白（CRP）明显降低（P＜0.05 或P＜0.01）结论：清热通腑法以五味消毒饮合小承气汤加减组方对脓毒症有较好的 干预治疗作用。 关键词：脓毒症；清热通腑法；五味消毒饮；小承气汤；临床疗效 Clinical research of therapy of Qingretongfu to treat Sepsis Speciality：Internal Medicine of Traditional Chinese Medicine Author ：Yan Su Tutor：Prof.You ke Abstract Objective：This research apply the therapy of Qingretongfu to treat patients with Sepsis，which may provide a new way for the treatment of Sepsis with the combination of Chinese medicine and western medicine. Methods: Our study was performed at the Affiliated Hospital of Shandong University of TCM. We conducted a prospective case-control study on 60 Sepsis patients in ICU from April 2011 to April 2012. The 60 patients were randomly divided into the treatment group and the contrast group. The contrast group was received common western medicine therapy and the other received Qingretongfu therapy except for the common western medicine therapy. On the first day before starts of treatment and Day 7 after the treatment, we recorded the APACHE Ⅱscore, and the investigated parameters. All data were analyzed with SPSS 17.0. Results: One week later, we found treatment group compared with contrast group, which was significant difference (P ＜0.05) .