参附注射液联合电针治疗脓毒症休克临床研究
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R459.7

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四川省医学会青年创新基金资助项目(川学会医字〔2017〕709号);四川省成都市中医重点专科(专病) 建设项目(2020)


Clinical Study on Shenfu Injection Combined with Electroacupuncture for Septic Shock
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    摘要:

    目的:观察参附注射液联合电针治疗脓毒症休克的疗效。方法:选取108 例脓毒症休克阳气暴脱证患者作为研究对象,按随机数字表法分为对照组及治疗组各54 例。2 组均予以脓毒症休克现代医学基础治疗,在此基础上治疗组加用参附注射液联合电针治疗。比较2 组治疗前及治疗6 h、12 h、24 h 平均动脉压(MAP)、中心静脉压(CVP)、中心静脉血氧饱和度(ScVO2)、乳酸、乳酸清除率及尿量的变化,比较2 组治疗前、治疗7 d 后急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ) 评分、序贯性器官衰竭(SOFA) 评分、受损器官数目的变化,观察2 组机械通气时间、使用血管活性药物时间、早期目标指导性复苏治疗(EGDT) 达标时间、重症医学(ICU) 住院时间及28 d 病死率。结果:治疗后,2 组各时间点MAP、CVP、ScVO2、乳酸清除率、尿量指标值均较治疗前上升,2 组各时间点乳酸指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,治疗组各时间点的MAP、CVP、ScVO2、乳酸清除率、尿量指标值均高于对照组,乳酸指标值低于对照组,差异均有统计学意义(P<0.05)。治疗组机械通气时间、使用血管活性药物时间、EGDT 达标时间均短于对照组,差异均有统计学意义(P<0.05)。治疗7 d 后,2 组APACHEⅡ评分、SOFA 评分及受损器官数目均较治疗前明显降低,治疗组上述3 项指标值均低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组ICU 住院时间短于对照组,差异有统计学意义(P<0.05);治疗后,对照组28 d 病死率为48.15%,治疗组为42.59%,2 组比较,差异无统计学意义(P>0.05)。结论:参附注射液联合电针治疗可改善脓毒症休克患者的预后,稳定血流动力学,改善组织灌注,阻止病情恶化。

    Abstract:

    Abstract:Objective:To observe the curative effect of Shenfu injection combined with electroacupuncture for septic shock. Methods:A total of 108 cases of patients with septic shock with sudden collapse of yang qi syndrome were selected as the study subjects, and were assigned into the control group and the treatment group according to the random number table method,with 54 cases in each group. Both groups were given basic treatment of modern medicine for septic shock,and the treatment group was additionally treated with Shenfu injection combined with electroacupuncture. Before treatment and after treatment for 6, 12 and 24 hours, the changes in mean arterial pressure(MAP), central venous pressure(CVP), low central venous oxygen saturation(ScVO2), lactic acid, lactate clearance rate and urine volume in the two groups were compared. Before treatment and after seven-day treatment,the changes in Acute Physiology and Chronic Health Evaluation(APACHEⅡ) scores,Sequential Organ Failure Assessment(SOFA) scores and the number of damaged organs in the two groups were compared. The duration of mechanical ventilation, time of using vasoactive drugs, time of reaching standard of early goal- directed therapy(EGDT), ICU hospitalization time and 28-day mortality in the two groups were observed. Results:After treatment,the values of MAP,CVP,ScVO2,lactate clearance rate and urine volume at each time point in the two groups were increased when compared with those before treatment, and the values of lactic acid at each time point in the two groups were decreased, differences being significant(P<0.05); the values of MAP, CVP,ScVO2,lactate clearance rate and urine volume at each time point in the treatment group were higher than those in the control group, and the value of lactic acid in the control group was lower, differences being significant(P<0.05). The duration of mechanical ventilation,time of using vasoactive drugs,time of reaching standard of EGDT in the treatment group were shorter than those in the control group,differences being significant(P<0.05). After seven- day treatment, the APACHE Ⅱ scores, SOFA scores and the number of damaged organs in the two groups were significantly decreased when compared with those before treatment,and the above three indexes in the treatment group were lower than those in the control group, differences being significant(P<0.05). After treatment, ICU hospitalization time in the treatment group was shorter than that in the control group, the difference being significant(P<0.05); the 28- day mortality was 48.15% in the control group and 42.59% in the treatment group,there being no significance in the difference(P>0.05). Conclusion:Shenfu injection combined with electroacupuncture for septic shock can improve the tissue perfusion and prognosis of patients with septic shock,stabilize the hemodynamics and prevent the deterioration of the disease.

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周智恩,卢萍,姚娟,杨梁.参附注射液联合电针治疗脓毒症休克临床研究[J].新中医,2022,54(19):116-120

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  • 在线发布日期: 2022-10-08
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