芪参活血颗粒对肺炎合并脓毒症患儿血清炎症反应的影响

摘要

目的 探讨芪参活血颗粒对肺炎合并脓毒症患儿血清炎症反应的影响.方法 选取2014年7月—2016年6月入住我院的138例肺炎合并脓毒症患儿作为研究对象.采用随机数字表法将患者分为观察组和对照组,每组69例.2组患者均给予常规西医对症支持治疗,观察组在此基础上联合芪参活血颗粒治疗.治疗结束后进行疗效评判;治疗前、治疗后7 d检测白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)、血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、CD4+CD25+调节性T淋巴细胞(Treg细胞)比例以及肌酸激酶同工酶(CK-MB)、肌酐(Scr)、天冬氨酸氨基转移酶(AST)、脑钠肽(BNP)水平;统计28 d病死率及治疗期住院时间;记录治疗期间不良反应事件.结果 观察组疗效明显优于对照组(89.86%vs.71.01%,P<0.01).治疗7 d后,2组IL-6、IL-10、TNF-α、PCT、hs-CRP水平及Treg细胞比例较治疗前均降低(P<0.05),且观察组L-6、IL-10、TNF-α、PCT、hs-CRP水平及Treg细胞比例低于对照组(P<0.05).2组治疗7 d后,CK-MB、Scr、AST、BNP水平均较治疗前明显下降,且观察组CK-MB、Scr、AST、BNP水平明显低于对照组(P<0.05).观察组28 d病死率及治疗期间住院时间均低于对照组(P<0.05).观察组和对照组均未见不良反应发生.结论 芪参活血颗粒有助于降低肺炎合并脓毒症患儿的炎症反应水平,提高治疗效果,且安全有效,值得临床推荐.%Objective To study the effect of Qishenhuoxue granule on serum inflammatory response in children with pneumonia complicated with sepsis. Methods A total of 138 children with pneumonia complicated with sepsis who were admitted to our hospital from July 2014 to June 2016 were enrolled in this study. Children were randomly divided into observation group and control group. The patients in both groups were treated with conventional Western medicine symptomatic support. The observation group was treated with Qishenhuoxue granule. The curative effect was determined after treatment. Interleukin-6 (IL-6), interleukin-10 (IL-10), tumour necrosis factor-α (TNF-α), serum procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), CD4+CD25+regulatory T cell (Treg cells) ratio value, creatine kinase-MB (CK-MB), creatinine (Scr), aspartic transaminase (AST) and brain natriuretic peptide (BNP) were measured before and 7 days after the treatment. Data of mortality and duration of pediatric intensive care unit (PICU) stay during treatment and adverse events were recorded during treatment. Results The total effective rate was 89.86% in the observation group, which was significantly higher than that of control group (71.01%, P<0.01). The levels of IL-6, IL-10, TNF-α, PCT, hs-CRP and Treg cell ratio were significantly lower after 7-day treatment in two groups than those before treatment (P<0.05), and levels of IL-6, IL-10, TNF-α, PCT, hs-CRP and Treg cell ratio were significantly lower in observation group than those in control group ( P<0.05). The CK-MB, Scr, AST and BNP were reduced after 7-day treatment in two groups, and those data were significantly lower in observation group than those of the control group (P<0.05). The 28-day mortality and the number of PICU days were significantly lower in observation group than those in control group (P<0.05). No adverse reactions were found in the both groups. Conclusion Qishenhuoxue granule can decrease the inflammatory response in children with pneumonia complicated with sepsis and improve the therapeutic effect. It is safe and effective and worthy of clinical recommendation.