【摘要】 目的:通过对心脏科体外循环(cardiopulmonary bypass,CPB)手术患者围术期中医证候指标的观测,判断复心煎干预对CPB手术患者免疫功能紊乱的中医证候的疗效,探讨CPB手术患者免疫功能紊乱的中医病因与发病机制及复心煎在心脏外科CPB手术中的临床应用。方法:需CPB心内直视瓣膜置换手术并中医辨证属气阴两亏或兼心血瘀阻的患者90例按完全随机分为3组,即复心煎术前干预组、复心煎术后干预组、对照组,每组各30例。观察记录每个患者术前7 d(T1)、术前1 d(T2)、术后1 d(T3)、术后8 d(T4)中医证候指标(临床症状)计分积分及积分减少率变化情况。结果:各组患者在T1时中医证候指标(临床症状)计分积分无统计学差异,具有可比性(P>0.05)。与对照组比较,复心煎术前干预组患者在T2、T3、T4时中医证候指标(临床症状)计分积分明显降低,积分减少率明显增加(P<0.05)。与对照组比较,复心煎术后干预组患者在T2、T3时中医证候指标(临床症状)计分积分及积分减少率无统计学差异(P>0.05);T4时计分积分明显降低,积分减少率明显增加(P<0.05)。结论:复心煎干预可明显改善CPB手术患者免疫功能紊乱的中医证候。更多还原

【Abstract】 Objective:To observe the indexes of syndromes of traditional Chinese medicine(TCM) in patients during the perioperative period of cardiopulmonary bypass(CPB)operations,and evaluate the effect of FuXinJian on TCM syndromes in patients with resistance mechanism disorders after CPB operations.In addition,to investigate the etiology and pathogenesis of resistance mechanism disorders after CPB operations,as well as the clinical application of FuXinJian in CPB operations.Methods:A total of 90 patients were divided into 3 groups according to completely randomized design,who needed CPB in open heart valve replacement surgery,as well as qi-deficiency and blood-stasis type or heart-blood stasis type.The 3 groups were the FuXinJian preoperative intervention group(n = 30),the FuXinJian postoperative intervention group(n = 30)and the control group(n = 30).The scores of indexes and the rates of score reduction of TCM symptoms(clinical symptoms)in patients were observed and recorded in 7 days before operations(T1),one day before operations(T2),one day after operations(T3),eight days after operations(T4).Results:The scores of the indexes of TCM symptoms(clinical symptoms) in patients of all of the 3 groups had no significant difference in T1,and the clinical data of the 3 groups had comparability(P > 0.05).Compared with the control group,the scores of the indexes of TCM symptoms decreased significantly in the first group in T2,T3 and T4,as well as the rates of score reduction increased significantly.No significant difference was detected in the scores of the indexes of TCM symptoms and the rates of score reduction between the second group and the control group in T2,T3.The scores of the indexes of TCM symptoms decreased and the rates of score reduction increased significantly in the second group in T4(P < 0.05).Conclusion:FuXinJian can effectively improve TCM syndromes of resistance mechanism disorders in patients after CPB operations.更多还原