中药灌肠联合血液净化对脓毒血症致早期急性肾损伤炎性因子水平的影响

摘要

Objective It is to study the clinical curative effect of enema with traditional Chinese medicine combined with blood purification on early acute renal injury caused by sepsis and the influence on inflammatory factor levels .Methods 160 cases of patients with early acute renal injury caused by sepsis were randomly divided into observation group and control group with 80 cases in each group .The control group was treated with continuous blood purification treatment , and the observation group was treated with Chinese medicine enema on the basis of the control group .The levels of serum hs -CRP, IL -6, IL-8, TNF -α, SCr, BUN, ALB, TP and Hb were determined before and after treatment in both groups , the APACHE Ⅱscores and SOFA scores were evaluated and the clinical efficacy of the two groups were compared .Pearson correlation analysis was used to analyze the relationship between various inflammatory indexes and SCr. Re sults The clinical efficient rates of the observation group and control group respectively were 98%and 82%, the curative effect in observation group was better than that in the control group (P<0.05).The serum levels of hs -CRP, IL -6, IL -8, TNF -α, SCr, BUN, ALB, TP and Hb and APACHE Ⅱscores, SOFA scores of the two groups were improved obviously compared with that before treatment ( P<0.05), and the improvements in observation group were more obvious than that in the control group (P<0.05).Pearson cor-relation analysis showed that there was a linear relation between the serum hs -CRP, IL -6, IL -8、TNF -αlevel and SCr, and the correlation was positive(P<0.05).Conclusion Traditional Chinese medicine enema combined continuous blood purification can obviously reduce the inflammatory factor levels of early acute renal injury caused by of sepsis , improve the pa-tient's kidney function , the clinical curative effect is distinct and is worthy of clinical popularization and application .%目的：探讨中药灌肠联合血液净化治疗脓毒血症致早期急性肾损伤的临床疗效及其对患者血清炎性因子水平的影响。方法将脓毒血症致早期急性肾损伤患者160例随机法分为观察组和对照组各80例。对照组给予连续血液净化治疗，观察组在对照组的基础上加用中药灌肠治疗。检测2组治疗前后血清高敏C反应蛋白（ hs－CRP ）、白细胞介素（IL）－6、IL－8、肿瘤坏死因子α（TNF－α）、血肌酐（SCr）、尿素氮（BUN）、白蛋白（ALB）、总蛋白（ TP）、血红蛋白（ Hb）水平，并进行APACHEⅡ评分和SOFA评分，评价2组的临床疗效，采用Pearson相关性分析进行炎性指标与SCr之间的关系评价。结果观察组和对照组的临床有效率分别为98％和82％，观察组疗效优于对照组（P＜0．05）；2组治疗后血清hs－CRP、IL－6、IL－8、TNF－α、SCr、BUN水平及APACHEⅡ评分、SOFA评分均较治疗前明显改善（P均＜0．05），且观察组改善情况明显优于对照组（ P均＜0．05）；Pearson相关性分析结果显示血清hs－CRP、IL－6、IL－8、TNF－α水平与SCr之间存在线性关系，呈正相关（P均＜0．05）。结论中药灌肠联合连续血液净化可明显降低脓毒血症致早期急性肾损伤患者血清炎性因子水平，改善患者的肾功能，临床疗效显著，值得临床推广应用。