参附注射液联合低剂量氢化可的松对重度脓毒血症患者炎症因子及免疫功能的影响

摘要

Objective To explore the effect of Shenfu injection combined with low dose hydrocortisone on immune function and expression of inflammatory factors in patients with severe sepsis. Methods 65 elderly patients with severe sepsis were randomly divided into the experiment group (33cases) and the control group (32 cases). The experiment group received Shenfu injection combined with low dose hydrocortisone, while the control group received basic treatment ( with antibiotic susceptibility+early fluid resuscitation +correct acidosis ) . The levels of TNF-α, IL-1β, IL-10 and T lymphocyte subsets were observed before and after the treatment. Results There was no signifi-cant difference in TNF-α, IL-1β, IL-10 and T lymphocyte subsets before treatment between the two groups ( P >0. 05) . In the control group, there was no significant difference in TNF-α, IL-1β, IL-10 and T lymphocyte subsets 1-day after the treatment. The levels of TNF-α, IL-1βand IL-10 decreased and T lymphocyte subsets increased 3 and 5 days after the treatment (P<0. 05). There were 17 cases improved, 8 cases progressed and 7cases died in the control group, while there were 24 cases improved, 7 cases progressed and 2 cases died in the experiment group 7 days after the treatment (χ2 =7. 74, P=0. 03). Conclusion The combination therapy of Shenfu injection and low dose hydrocortisone can improve the immune function in patients with severe sepsis more effectively.%目的：观察参附注射液联合低剂量氢化可的松对重度脓毒血症患者炎症因子及免疫功能的影响。方法65例重度脓毒血症患者按数字随机法分为对照组与观察组。对照组(32例)接受基础治疗(抗生素+早期液体复苏+纠正酸中毒等),观察组(33例)在此基础上应用参附注射液与低剂量氢化可的松联合治疗。分别在治疗前、后检测肿瘤坏死因子α( TNF-α)、白细胞介素-1β( IL-1β)、白细胞介素-10( IL-10)的浓度和外周血T淋巴细胞亚群情况。结合患者7天内的病情情况分析参附注射液联合低剂量氢化可的松对重度脓毒血症患者的治疗效果及对免疫功能的影响。结果治疗前,两组患者TNF-α、IL-1β、IL-10的浓度和外周血T淋巴细胞亚群的情况差异无统计学意义(P>0．05)。与对照组比较,观察组治疗后1天时肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)的浓度和外周血T淋巴细胞亚群,差异无统计学意义(P>0．05)；观察组治疗后3天和5天肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)的浓度水平降低和外周血T淋巴细胞亚群数目增加,差异有统计学意义(P<0．05)；对照组治疗后7天对照组好转17例,迁延8例、死亡7例,观察组好转24例,迁延7例、死亡2例,差异有统计学意义(χ2=7．74,P=0．03)。结论参附注射液联合低剂量氢化可的松可促进患者的转归,与调节机体免疫功能、减轻炎症反应有关。