黄连解毒汤加减治疗热毒型脓毒症临床研究

目的:观察黄连解毒汤治疗热毒型脓毒症的临床疗效。方法:选择热毒型脓毒症患者115例,随机分为两组,对照组给予常规治疗,观察组在常规治疗基础上加用黄连解毒汤加减治疗,7 d为1个疗程,分别于治疗前、治疗后第3天、第7天进行中医证侯积分评定,同时采用急性生理及慢性健康评分Ⅱ、器官功能障碍评分对两组患者病情进行评分,记录体温、心率变化,检测白细胞总数、中性粒细胞总数、C反应蛋白、降钙素原、白细胞介素-6、肿瘤坏死因子-α、空腹血糖指标。结果:观察组的临床疗效明显优于对照组,观察组的中医证侯积分下降优于对照组,差异均有统计学意义(P0.05)。两组急性生理及慢性健康评分Ⅱ、器官功能障碍评分、体温、心率、白细胞总数、中性粒细胞总数、C反应蛋白、降钙素原、白细胞介素-6、肿瘤坏死因子-α、空腹血糖均较治疗前显著下降(P0.05),且观察组相关指标的降低明显优于对照组,差异具有统计学意义(P0.05)。两组在安全性评价方面无显著性差异,治疗方案均是安全可行的。结论:黄连解毒汤加减治疗热毒型脓毒症具有确切的临床疗效,能明显改善脓毒症患者的炎症因子水平,同时更加有利于血糖的控制。

Clinical Study on Huanglian Jiedu Tang in the Treatment of Heat-Toxin Type of Sepsis

Objective:To observe the clinical effect of Huanglian Jiedu Tang in the treatment of heat-toxic type in sepsis.Methods:115 patients were randomly divided into two groups,55 cases in the control group and 60 cases in the observation group.The control group was given routine treatment,the observation group on the basis of routine treatment with Huanglian Jiedu Tang,treatment for 7 days.The scores of TCM syndromes were evaluated before treatment,3 d after treatment,and 7 d after treatment,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),organ dysfunction score were evaluated two groups of patients,including body temperature,heart rate,white blood cell count (WBC),the total number of neutrophils (NEU),creaction protein (CRP),procalcitonin (PCT),interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α),blood glucose index.Results:After treatment,the clinical efficacy of the observation group was significantly higher than that of the control group,and the score of TCM syndrome in the observation group decreased better than that in the control group,with statistical difference (P ＜ 0.05).After treatment,two groups of APACHE Ⅱ,organ dysfunction score,body temperature,heart rate,white blood cell count,neutrophil count,C reaction protein,procalcitonin,interleukin-6,tumor necrosis factor alpha and fasting blood glucose were lower than that before treatment (P ＜ 0.05),and the observation group related indexes were significantly lower than those of control group,the difference was statistically significant (P ＜ 0.05).There was no significant difference between the two groups in the safety evaluation,and the two groups were safe and feasible.Conclusion:Huanglian Jiedu Tang has exact clinical efficacy in the treatment of heat-toxic type of sepsis,significantly improve the level of inflammatory factors in patients with sepsis,and more conducive to the control of blood sugar.