中医药干预对脓毒症患者预后相关指标的影响

目的 观察中医药治疗对脓毒症患者血糖、急性生理及慢性健康状况评价系统（APACHEⅡ）评分、血乳酸、碱剩余、血清降钙素原及超敏C反应蛋白的影响.方法 将100例患者随机分为两组,西医治疗组给予抗感染等西医常规治疗,中西医结合治疗组在西医治疗组治疗基础上予清热解毒中药鼻饲.比较两组用药前后的7点血糖平均值、APACHEⅡ评分、血乳酸、碱剩余、血清降钙素原及超敏C反应蛋白的数值,比较两组胰岛素用量的差别.结果 中西医结合治疗组的APACHEⅡ评分、血乳酸、碱剩余及血清降钙素原、超敏C反应蛋白改善情况均优于西医治疗组（P＜0.05）,疗后7点两组血糖平均值相当（P＞0.05）,但中西医结合治疗组的胰岛素用量较西医治疗组明显减少（P＜0.05）.结论 中医药能有效改善脓毒症患者的APACHEⅡ评分、血乳酸、碱剩余、血清降钙素原及超敏C反应蛋白值,减少胰岛素用量,对脓毒症有良好的治疗作用.

Effect of Chinese Medicine Intervention on Indices Related to Prognosis of Patients with Sepsis

Objective：To observe the effect of TCM on blood glucose,acute physiology,chronic health evaluation（APACHE Ⅱ）,blood lactic acid,base excess,serum calcitonin,and high-sensitivity C reactive protein in patients with sepsis.Methods：100 cases were randomly divided into western medicine control group,which was given anti-infection and other routine western medicine treatment,and treatment group,which was given combination of TCM and western medicine.7 days after treatment,7 point mean blood glucose values,APACHE Ⅱ score,blood lactic acid,base excess,serum procalcitonin,and high-sensitivity C reactive protein of both groups before and after treatment were compared.Insulin dosage of the two was also compared.Results：APACHE Ⅱ score,blood lactic acid,base excess,serum procalcitonin,and high sensitive C reactive protein of treatment group improved better than those indicators of western medicine control group.There was no significant difference at 7point mean blood glucose values of both groups,but the dosage of insulin used in treatment group was significantly less than that in western medicine control group.Conclusion：Traditional Chinese medicine can effectively improve the APACHE Ⅱ score,blood lactic acid,base excess,serum procalcitonin,and high-sensitivity C reactive protein in patients with sepsis,reduce the amount of insulin,thus has a good therapeutic effect on sepsis.