加味凉隔散对脓毒症患者血小板活化及凝血功能影响的临床研究

目的:探讨加味凉隔散对脓毒症患者血小板活化及凝血功能的影响。方法:将58例无凝血功能障碍的脓毒症患者随机分为A组(西医常规综合治疗,29例)与B组(西医常规综合治疗+加味凉隔散鼻饲,29例),健康志愿者10例为对照组C组,分别检测C组血小板膜糖蛋白CD62p、CD63的表达和A、B组患者治疗前及治疗后血小板膜糖蛋白CD62p和CD63的表达和凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板(PLT)计数情况,并进行急性生理学和慢性健康状况Ⅱ(APACHEⅡ)评分及患者28天生存率观察。结果:两组患者入院当天血小板膜糖蛋白CD62p和CD63表达较健康对照组明显升高,两组患者治疗后CD62P,CD63均显著降低,且B组降幅更为显著(P<0.05);两组患者治疗后PT、TT、APTT均缩短,FIB和PLT均升高,且B组较A组改善程度更为显著;两组患者28天生存率比较差异无统计学意义。结论:加味凉隔散有抑制脓毒症患者血小板活化及改善凝血功能的作用。

Clinical trial of Effects of Modified Liangge San on Platelets Activation and Coagulation Function in Patients with Sepsis

Objective：To investigate the effects of Modified Liangge San on Platelets Activation and Coagulation Function in Patients with Sepsis.Methods：58 septic patients with normal blood coagulation were randomly divided into two groups：29 cases received the western medicine only（group A） and 29 cases were treated by the western medicine combined with modified Liangge san nasal tube.10 healthy volunteers were taken as the control group（group C）.The expressions of CD62p,CD63 in peripheral platelets in the group C and the expressions of CD62p,CD63 in peripheral platelets and prothrombin time（PT）,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,the number of platelets（PLT） in the groups A B before and after treatment were detected.Meanwhile,APACHE II score and 28-day mortality were monitored and compared.Results：Compared with group C The expressions of CD62p,CD63 in peripheral platelets of the septic patients was significantly higher,and significantly reduced after treatment,furthermore,these of group B were lower than those of group A（P〈0.05）.PT and APTT all decreased,while both FIB and PLT increased of the septic patients,and the degree of improvements in group B was more significant than that in group A.There was no significant difference in 28-day mortality between group B and group A.Conclusion：Modified Liangge San has the efficacy of inhibiting platelets activation and improving coagulation function.