大黄对全身炎症反应综合征患儿炎性因子和补体的影响及意义

目的：研究大黄对全身炎症反应综合征（SIRS）患儿的治疗作用及其作用机制。方法：78例SIRS患儿入院时随机分为大黄治疗组（简称大黄组）40例及常规治疗组（简称常规组）38例，大黄组在常规组治疗基础上给予生大黄粉口服或鼻饲，入院时及入院后第3日用ELISA法测定血清肿瘤坏死因子（TNF－α）；用全自动散射比浊定量分析法测定C反应蛋白（C－RP）、补体（C3、C4），并进行比较。结果：大黄组治愈率明显高于常规组，病死率明显降低。SIRS患儿入院时血清TNF－α、C－RP、C3及C4显著高于正常对照组，随着病情缓解，上述指标有不同程度下降，且大黄组下降更明显。结论：大黄能改善SIRS患儿的预后，其主要机制是大黄对炎性因子和补体有拮抗作用。

Effect of Rhubarb on Inflammatory Cytokines and Complements in Patients with Systemic Inflammation Reaction Syndrome and Its Significance

OBJECTIVE: To study the effect of rhubarb in treating patients with systemic inflammation reaction syndrome (SIRS) and its mechanism. METHODS: The 40 patients with SIRS in the treated group were treated with conventional treatment plus rhubarb powder orally or by nasal feeding, the 38 patients in the control group were treated with conventional treatment alone. Serum tumor necrosis factor-alpha (TNF-alpha) was determined by ELISA during the admission and the 3rd day after admission, C-reactive protein (C-RP), complement 3 and 4 (C3, C4) were also determined by auto-scattering turbidimetric quantitative analysis. The parameters were compared between groups and with normal control group. RESULTS: Cure rate in the treated group was significantly higher than that in the control group accompanied with lesser occurrence of multiple organ dysfunction syndrome (MODS) and lower mortality. Serum TNF-alpha, C-RP, C3 and C4 in the SIRS patients were increased during admission, which were significantly higher than normal control, but these parameters would be reduced together with the alleviating of symptoms after treatment, particularly after rhubarb treatment. CONCLUSION: Rhubarb could improve the prognosis of patients with SIRS, its major mechanism is that rhubarb has the antagonizing effect against inflammatory cytokines and complements.