通腑泻热方对外科脓毒症患者降钙素原和免疫功能影响

目的：观察通腑泻热方对外科脓毒症患者降钙素原（PCT）和免疫功能的影响。方法：将患者60例随机分为治疗组和对照组,两组在西医常规治疗的基础上,治疗组给予通腑泻热方灌肠,对照组给予生理盐水灌肠。观察两组患者在治疗前和治疗后第3、7、14天血中降钙素原（PCT）、T淋巴细胞亚群（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋）和CD14＋单核细胞人白细胞DR抗原（HLA-DR/CD14＋）的变化情况,同时也观察并发症的发生情况及住院时间。结果：两组PCT均有下降,但与对照组比较,治疗组PCT下降更明显,差异有显著性（P〈0.01）;两组CD3＋、CD4＋、CD8＋、CD4＋/CD8＋、HLA-DR/CD14＋均有升高,但只有第7、14天治疗组较对照组有显著差异（P〈0.01）;治疗组并发症和住院时间较对照组显著减少（P〈0.01）。结论：通腑泻热方能降低外科脓毒症患者血清降钙素原水平,提高机体免疫功能,具有减轻全身炎症反应和免疫调理作用;能降低并发症的发生率,预防MODS发生,从而降低病死率,同时也缩短患者住院时间。

Effect of Tongfu Xiere Recipe on Procalcitonin and Immune Function of Patients with Surgical Sepsis

Objective：To observe the effect of Tongfu Xiere Recipe on procalcitonin and immune function of patients with surgical sepsis. Method ： The patients with 60 cases were randomly divided into treatment group and control group. Two goups were based on western conventional treatment. The treatment group was given Chinese medicine Tongfn Xiere Recipe for enema, and the control group was given physiological saline for enema. Before and 3,7,14 days after treatment, PCT, CD3＋, CD4＋, CD8＋, CD4＊/CD8＋and HLA-DR/CD14＋ in two groups of patients were observed, the happening of complications and hospitalization time were also observed. Result ： The PCT of two groups was decreased, but compared with control group, the PCT of treatment group was decreased more significantly, there were significant differences （ P〈0.01 ）. The CD3＋, CD4＋, CD8＋, CD4＋ / CD8＋, HLA - DR/CD14＋ of two groups of were increased, but only on the 7,14 day, compared with control group, there were significant differences （ P〈0.01 ）. Complications and length of hospital stay were significantly reduced in treatment group （ P〈0.01 ）. Conclusion ： Tongfu Xiere Recipe can reduce the level of procalcitonin in patients with surgical sepsis, improve immune function, attenuate the systemic inflammatory response and recuperate immune, reduce the incidence of complications and prevent MODS, in order to reduce mortality, but also shorten hospital stay.