参附注射液对严重脓毒症患者炎症细胞因子及预后影响.doc

参附注射液对严重脓毒症患者炎症细胞因子及预后影响（温州医学院附属第六医院重症医学科，浙江 丽水 323000） 摘 要：目的：观察参附注射液对严重脓毒症患者的临床疗效和作用机制。方法：将68例严重脓毒症患者随机分为参附注射液治疗组（36例）和对照组（32例）。在相同的常规西医治疗（参照2008年SSC制定的“脓毒症治疗指南”）基础上，治疗组加用参附注射液100mL，静脉滴注，每天1次，持续7天。分别于治疗前、治疗后第3天、第7天进行APACHEII评分和Mashall评分；并记录两组患者28天死亡率。采用酶联免疫吸附法（EISA）测定血清白介素-6（IL-6）、IL-10的动态水平。结果：两组患者治疗前APACHE II评分、Mashall评分、IL-6和IL-10水平的差异无统计学意义（P0.05 ）。经治疗后两组患者APACHEII和 Mashall评分均有下降，但治疗组下降更明显（P0.05），但治疗组死亡患者平均存活时间为15.52天，对照组为11.10天，两组比较差异有统计学意义（P0.05）。结论：参附注射液能够改善严重脓毒症患者的总体病情，延长其生存时间，其作用机制可能与它调节严重脓毒症患者促炎因子和抗炎因子的平衡有关。 关键词：参附注射液；严重脓毒症；白细胞介素-6；白细胞介素-10；预后 中图分类号：R285.6文献标识码：B文章编号：1673-7717（2011）03-0525-03 收稿日期：2010-11-27 基金项目：浙江省中医药科技计划资助项目（2009CB084） 作者简介：张宁（1973-），男，浙江义乌人，副主任医师，硕士，研究方向：中西医结合治疗脓毒症的临床与科研工作。 Influence of Shenfu Injection on Inflammatory Cytokines and Prognosis in Patients with Severe Sepsis ZHANG Ning, QIU Ze-liang, YE Yi-ping, XU Jun-long, LOU Tian-zheng, LEI Hou-xing （Department of Intensive Care Unit，Sixth Affiliated Hospital of Wenzhou Medical College，Lishui 323000，Zhejiang, China） Abstract:Objeetive: To evaluate the clinical therapeutic efficacy of Shenfu injection on patients with severe sepsis and approach its therapeutic mechanism. Methods: Sixty-eight patients with severe sepsis were divided into a Shenfu group（36 cases） and a control group（32 cases）；The two groups were treated with conventional therapy of western medicine （According to International guidelines for management of severe sepsis and septic shock: 2008 from surviving Sepsis Campaign）. And the treated group was received 100mL Shenfu injection intravenous drip once a day at the base of conventional therapy. The therapeutic course of both groups was 7 days. The acute physiology and chronic health evaluation II （APACHE II ）score and Mashall score were observed before and on the 3rd, the 7th day after treatment, and the 28d mortality rate were observed. the serum levels of interleukin-6（IL-6） and IL-10 were measured by enzyme-labeled immunosorbent as