黄连解毒汤联合西药治疗脓毒症心肌损伤疗效研究

目的:探讨黄连解毒汤治疗脓毒血症心肌损伤(SIMD)患者的临床疗效和预后.方法:选取68例SIMD患者,随机为对照组(n=34)和观察组(n=34).对照组给予集束化等综合治疗,观察组在对照组基础上联合运用黄连解毒汤.比较两组心肌损伤指标[心肌肌钙蛋白I(cTnI)、氨基末端脑钠肽前体(NT-proBNP)和肌酸激酶同...

Study on clinical efficacy of Huanglian Jiedu decoction combined with western medicine on myocardial injury caused by sepsis

Objective:To investigate the effect of Huanglian Jiedu decoction on clinical efficacy and prognosis of patients with sepsis-induced myocardial injury(SIMD).Methods:68 patients with SIMD were randomly divided into control group(n=34)and observation group(n=34).The control group was given cluster therapy and other comprehensive treatment.The observation group was treated with Huanglian Jiedu decoction on the basis of the control group.The cardiac injury indexes[cardiac troponin I(cTnI),amino-terminal brain natriuretic peptide precursor(NT-proBNP)and creatine kinase isoenzyme(CK-MB)],cardiac function indexes[left ventricular ejection fraction(LVEF),filling peak of early left ventricular diastolic rapid filling and filling peak of atrial contraction filling(E/A),and cardiac output per stroke(SV)],serum superoxide dismutase(SOD),lactic acid(Lac)and procalcitonin(PCT)levels were compared between the two groups.Acute physiology and chronic health status scoreⅡ(APACHEⅡ),sequential organ failure(SOFA)score,TCM syndrome score,clinical efficacy and prognosis were compared between the two groups.Results:After treatment,the levels of serum cTnI,NT-proBNP and CK-MB in both groups were decreased,and above indicators in the observation group were lower than the control group,difference statistically significant(all P<0.01).After treatment,the levels of LVEF,E/A and SV were increased,and above indicators in the observation group were higher than those in the control group,difference statistically significant(all P<0.01).Compared with before treatment,after treatment the levels of serum PCT and Lac were decreased,SOD increased,difference statistically significant(all P<0.01).After treatment,the levels of serum PCT and Lac in the observation group were lower than those in the control group,and SOD higher than that in the control group,difference statistically significant(all P<0.01).After treatment,the scores of APACHEⅡ,SOFA and TCM syndrome in both groups decreased,and above scores in the observation group were lower than those in the control group,difference statistically significant(all P<0.05).The total effective rate in the observation group was higher than that in the control group,and the ICU transfer rate in the observation group higher than that in the control group,difference statistically significant(all P<0.01).Conclusion:Huanglian Jiedu decoction can improve clinical efficacy,alleviate myocardial injury,protect myocardial tissue and improve prognosis in the treatment of septic myocardial injury.