清气凉营汤对脓毒症患者HMGB1、sRAGE及免疫功能的影响

目的探析清气凉营汤对脓毒症(Sepsis)患者HMGB1、sRAGE及免疫功能的影响。方法收集本院2019年8月至2020年2月急诊留观室、ICU收治的Sepsis患者60例,单盲试验原则,数字标注法随机分组,对照组30例,采用西医标准治疗方案,清气凉营组30例,在标准方案基础上联合清气凉营汤用药。比较两组治疗前、治疗7 d血清HMGB1与血浆sRAGE水平、CD4+、CD8+水平及急性生理学及慢性健康状况评分系统(APACHEⅡ)评分,记录28 d病死率。结果两组治疗7 d后APACHEⅡ评分、血清HMGB1与血浆sRAGE水平显著低于治疗前(P<0.05);且清气凉营组治疗7 d后APACHEⅡ评分、血清HMGB1与血浆sRAGE水平改善幅度显著优于对照组(P<0.05)。两组治疗7 d后CD4+、CD8+均明显高于治疗前(P<0.05),且清气凉营组改善幅度显著优于对照组(P<0.05)。清气凉营组患者治疗28 d死亡率显著低于对照组(P<0.05)。结论清气凉营汤治疗脓毒症效果良好,能降低患者HMGB1、sRAGE水平,抑制炎症因子过表达,调节机体免疫功能,促进自身免疫系统恢复稳态,减低病死风险。

Effects of Qingqi Liangying Decoction on HMGB1,sRAGE and Immune Function in Patients with Sepsis

Objective:To explore the effect of Qingqi Liangying Decoction on HMGB1,sRAGE and immune function in patients with sepsis.Methods:A total of 60 patients with sepsis admitted to the emergency observation room and ICU in our hospital from August 2019 to February 2020 were collected.The principle of singleblind trial was randomized by number labeling.The control group(30 cases)was treated with western medicine standard treatment plan;the Qingqi Liangying group(30 cases)was combined with Qingqi Liangying Decoction on the basis of the standard plan.The serum HMGB1 and plasma sRAGE levels,CD4+,CD8+ levels and acute physiology and chronic health score system(APACHEⅡ)scores were compared between the two groups before treatment and 7 days after treatment,and the 28-day mortality rate was recorded.Results:The APACHEⅡ score,serum HMGB1 and plasma sRAGE levels after 7 days of treatment in the two groups were significantly lower than those before treatment(P<0.05),and the levels of improvement in the APACHEⅡ score,serum HMGB1 and plasma sRAGE in the Qingqi Liangying group after 7 days of treatment was significantly better than the control group(P<0.05).The CD4+ and CD8+ levels of the two groups after 7 days of treatment were significantly higher than those before treatment(P<0.05),and the improvement of CD4+,CD8+ levels in the Qingqi Liangying group after7 days of treatment was significantly better than that of the control group(P<0.05).The 28-day mortality rate of patients in the Qingqi Liangying group was significantly lower than that of the control group(P<0.05).Conclusion:Qingqi Liangying Decoction has a good effect in the treatment of sepsis.It reduces the levels of HMGB1 and sRAGE in patients,inhibits the overexpression of inflammatory factors,regulates the body′s immune function,promotes the restoration of the autoimmune system to a stable state,and reduces the risk of death.