参附注射液对多发伤合并休克的治疗作用

摘要

目的 探讨参附注射液对多发伤合并休克的治疗作用.方法 将90 例多发伤合并休克患者按随机原则分为参附注射液治疗组(治疗组)和常规治疗对照组,每组45 例.两组均采用多发伤常规治疗;治疗组在此基础上加用参附注射液50 ml 静脉滴注,每12 h 1 次,连续5d.于入院即刻、治疗3d 、5d 取血3 ml,用双抗体夹心酶联免疫吸附试验(ELISA )检测肿瘤坏死因子-α(TNF-α)白细胞介素(IL-1 、IL-6 )水平;并观察两组重症监护病房(ICU )治疗时间、多器官功能障碍综合征(MODS )发生率、、病死率.结果 两组治疗3 d TNF-α(ng/L)、IL-1(μg/L)、IL-6(ng/L )均较入院即刻明显升高,治疗5d 均较治疗3d 明显降低,治疗组治疗3d 和5 d TNF-α、IL-1 、IL-6 水平均低于同期对照组,且以治疗5d 降低更显著(P＜0.05 或P＜0.01);治疗组ICU 治疗时间(d)、MODS 发生率、病死率均较对照组明显降低(ICU 治疗时间:6.01±1.73 比10.02±1.69,MODS 发生率:20% 比41%,病死率:12.8% 比30.0%,均P＜0.05).结论 参附注射液能抑制炎症因子的释放,降低MODS 的发生率,从而改善预后.%Objective To explore the effects of Slienfu injection on patients of multiple traumas complicated with shock. Methods Ninety patients of multiple traumas complicated with shock were randomly divided into Shenfu injection group (treatment group) and conventional treatment control group (control group, each 45 cases). Conventional treatment for multiple traumas was given to the two groups. On the base of conventional therapy, the treatment group was additionally given Shenfu injection 50 ml intravenous infusion, once every 12 hours for 5 consecutive clays. Immediately after hospitalization, after treatment for 3 clays ancl 5 days, 3 ml blood sample was obtained, the levels of tumor necrosis factor-α (TNF-α ) and interleukin (IL-1, IL-6) were detected with double-antibody sandwich enzyme-linked imrnunosorbent assay (ELISA), the duration of stay in intensive care unit (ICU), the incidence of multiple organ dysfunction syndrome (MODS) and the mortality in the two groups were observed. Results In both groups, after treatment for 3 days, the levels of TNF-a (ng/L), IL-1 (ng/L) and IL-6 (ng/L) were significantly higher than those immediately after admission ; after 5 days of treatment, the above indexes were reduced obviously compared with those on the 3rd day. The levels of TNF-α, IL-1 and IL-6 of the treatment group after treatment for 3 days and 5 days were lower than those of control group at the same time points, and the range of reduction was more significant on the 5th day after treatment (P＜0.05 or P＜0.01) ; the duration of stay in ICU (day), the incidence of MODS and mortality in treatment group were significantly lower than those in the control group(the duration of stay in ICU : 6.01 ±1.73 vs. 10.02 ±1.69, MODS incidence : 20% vs. 41%, mortality : 12.8% vs. 30.0%, all P＜0.05). Conclusion Shenfu injection can inhibit the release of inflammatory factors, reduce the incidence of MODS and improve the prognosis in cases of multiple traumas.