四逆汤对脓毒性休克患者目标导向性治疗和血清炎性因子的影响

摘要

目的:观察四逆汤对脓毒性休克目标导向性治疗的影响,同时分析对部分血清炎性因子的影响.方法:选取2013年3月至2016年2月重庆市开州区人民医院收治的适合进行目标导向性治疗的浓毒性休克患者90例,随机分为观察组和对照组,每组45例.观察组患者接受目标导向性治疗和四逆汤;对照组仅接受目标导向性治疗.比较2组患者中医证候,达标所需时间、参数以及部分血清炎性反应指标等.结果:观察组中医证候效果优于对照组(P<0.05);2组治疗后达目标所需要时间分别为(4.13 ±2.10)d、(8.45 ±1.89)d,观察组达标时各参数均显著高于对照组(P<0.05);2组治疗后炎性因子有所下降,与对照组比较,观察组治疗后炎性因子水平更低(P<0.05).结论:四逆汤能有效地脓毒性休克目标导向性治疗其作用机制可能与降低TNF-α、IL-8等血清炎性因子表达有关.%Objective:To observe the clinical curative effect of Sini decoction on Septic shock with Goal -directed therapy(GDT), at the same time analyze the influence on the hematology inflammatory indexes.Methods:A total of 90 cases of septic shock patient in our hospital from March 2013 to February 2016 were included in the study,and randomly divided into the control group and the observation group,with 45 cases in each group.The control group accepted basic treatment.Besides,the observation group was trea-ted combined with Sini decoction on the basis treatment of the control group.The clinical syndrome integrals,time of meeting the standard,CVP,MAP,TNF-αand IL-10 changes in serum concentration levels of two groups before and after treatment were ob-served.Results:1)The improvement of TCM syndrome integrals of observation group was more significantly than the control group (P<0.05).2)The time of meeting the standard in observation group and treatment group were(4.13 ±2.10)d and(8.45 ± 1.89)d respectively.The index of the observation group was higher than the control group at the time of meeting the standard(P<0.05).The downward trend of the observation group was more obvious when compared with the control group,and the statistical differences were significant(P<0.05).3)Detected by ELISA test,TNF-αand IL-10 levels of the two groups of the patient de-creased after treatment with significant differences(P<0.05).Conclusion:The modified Sini decoction can effectively treat septic shock patient,and the mechanism may related to the reduction of inflammation level.