解毒益气活血方改善严重脓毒症患者免疫功能的机制研究

目的:探讨解毒益气活血方对严重脓毒症患者免疫功能的影响及临床疗效。方法:选择ICU严重脓毒症患者63例,随机分为对照组(31例,采用西医治疗)和治疗组(32例,采用西医治疗加解毒益气活血方)。分析比较两组患者治疗前及治疗后5、10天相关免疫学指标、APACHEⅡ评分、机械通气时间、住ICU时间及28天病死率的情况。结果:与对照组相比,治疗组治疗后TNF-α、IL-6、IL-10明显下降,IgG水平、淋巴细胞计数、CD4+T淋巴细胞水平及CD1+4单核细胞HLA-DR表达明显上升,住ICU时间明显缩短,28天病死率明显下降(P0.05或P0.01)。结论:解毒益气活血方结合西医治疗能调节患者的免疫功能,改善严重脓毒症患者病情和预后。

Study on Mechanism of Jiedu Yiqi Huoxue Recipe Improving Immune Function of Severe Septic Patients

Objective:To explore the effect on immunologic function and the therapeutic efficacy of Jiedu Yiqi Huoxue Recipe(JYHR)treating severe sepsis.Methods:Sixty-three patients with severe sepsis in intensive care unit(ICU)were enrolled and randomly assigned to two groups.Thirty-one patients in the control group were treated with western medicine alone,thirty-two patients in the therapy group were treated with western medicine combined with JYHR.Changes of the immune index and APACHE Ⅱ score before and after therapy in the 5th,7th day,the duration of mechanical ventilation,ICU stay time and 28-day mortality were monitored and compared.Results:Compared with the control group,levels of TNF-α,IL-6 and IL-10,ICU stay time and 28-day mortality were significantly lower in the therapy group(P<0.05 or P<0.01),IgG level,the lymphocytes,CD+4 T lymphocytes and level of CD+14 monocytes HLA-DR in the therapy group increased significantly(P<0.05 or P<0.01).Conclusion:JYHR combined with western medicine can regulate the immunologic function and improve illness state and the outcome of severe sepsis.