【摘要】 目的观察参附注射液联合西医综合治疗严重脓毒症休克患者的效果。方法选取我院重症医学科2016年7月～2018年3月收治的68例脓毒症休克患者,按照随机数字表法分为观察组和对照组,各34例。对照组给予常规西医综合治疗,观察组在西医综合治疗基础上辅以参附注射液治疗,疗程1周。比较两组患者的序贯器官衰竭估计评分（SOFA）、急性生理与慢性健康状况评分（APACHE-Ⅱ）、组织灌注改善情况及炎症因子水平变化。结果两组患者治疗后的SOFA、APACHE-Ⅱ评分均下降（P<0.05）;观察组治疗后的SOFA、APACHE-Ⅱ评分低于对照组,差异有统计学意义（P<0.05）。两组患者治疗后的乳酸（Lac）、氧摄取率（O₂ER%）水平降低,尿量、中心静脉血氧饱和度（ScvO₂）、氧输送量（DO₂）、氧消耗量（VO₂）水平升高（P<0.05）;观察组治疗后的Lac、O₂ER%水平低于对照组,尿量、ScvO₂、DO₂、VO₂水平高于对照组,差异有统计学意义（P<0.05）。两组患者治疗后的肿瘤坏死因子-α（TNF-α）、血清降钙素原（PCT）、IL-1、IL-6和IL-10水平降低,观察组治疗后的TNF-α、PCT、IL-1、IL-6和IL-10水平均低于对照组,差异有统计学意义（P<0.05）。结论参附注射液辅助治疗脓毒症休克能够明显改善患者全身灌注状态及氧代谢情况,减轻全身炎症反应,降低SOFA评分和APACHEⅡ评分,具有较高的临床实用价值。更多还原

【Abstract】 Objective To observe the efficacy of Shenfu Injection combined with Western medicine in the treatment of severe septic shock patients. Methods A total of 68 patients with septic shock admitted to our department of critical Care Medicine from July 2016 to March 2018 were enrolled. According to the random number table method, they were divided into the observation group and the control group, with 34 cases in each group. In the control group, regular comprehensive treatment of Western medicine was used, while in the observation group, on the basis of the control group,Shenfu Injection was added. The course of treatment was 1 week. The sequential organ failure assessment score（SOFA）,acute physiology and chronic health evaluation Ⅱ（APACHE-Ⅱ） score, improvement of tissue perfusion, and changes of inflammatory factor levels were compared in the two groups. Results After treatment, the SOFA and APACHE-Ⅱscores of the two groups both decreased（P<0.05）. The SOFA and APACHE-Ⅱ scores in the observation group after treatment were lower than those in the control group（P<0.05）. After therapy, the levels of lactic acid（Lac） and oxygen uptake rate（O₂ ER%） both decreased, and the urine volume, central venous oxygen saturation（ScvO₂）, oxygen delivery（DO₂）, and oxygen consumption（VO₂） levels also increased（P<0.05）. After therapy, the levels of Lac and O₂ ER% in the observation group were lower compared with those in the control group, and the urine volume, ScvO₂, DO₂, VO₂ levels were higher than those of the control group, with statistical differences（P<0.05）. The levels of tumor necrosis factor-α（TNF-α）, serum procalcitonin（PCT）, interleukin-1（IL-1）, IL-6 and IL-10 decreased in the two groups after treatment,the TNF-α, PCT, IL-1, IL-6 and IL-10 levels were lower in the observation group than the control group, with significant differences（P<0.05）. Conclusion Shenfu Injection as an adjuvant therapy can remarkably improve the systemic perfusion status and oxygen metabolism, reduce systemic inflammatory response, and decrease the SOFA and APACHE-Ⅱ scores, and has a high clinical pragmatic value.更多还原