目的：观察参附注射液对严重脓毒症患者的临床疗效及对T淋巴细胞亚群（CD3+、CD4+、CD8+）、NK细胞、单核细胞人白细胞DR抗原（HLA- DR）表达率的影响。方法将68例严重脓毒症患者随机分为西医常规治疗基础上加用参附注射液治疗组（参附组，36例）和单纯西医常规治疗组（对照组，32例）。观察治疗前及治疗后第3、7天患者临床疗效及T淋巴细胞亚群、NK细胞、单核细胞HLA- DR表达率的变化。结果两组患者治疗前APACHE II、Marshal 评分、IL-6和IL-10水平的差异均无统计学意义（均P＞0.05）；与健康对照组比较，严重脓毒症患者血清IL-6、IL-10和CRP水平明显升高，CD3+、CD4+、CD8+T淋巴细胞和单核细胞HLA- DR表达降低（均P＜0.05）。与对照组同期比较，治疗后第7天参附组APACHEII、Marshal 评分及IL-6和CRP水平均下降，而CD3+、CD4+、CD8+T淋巴细胞、NK细胞及单核细胞HLA- DR表达均升高，差异均有统计学意义（均P＜0.05）。结论严重脓毒症患者全身炎症反应和免疫抑制同时存在；参附注射液具有维持促炎/抗炎平衡，双向调节严重脓毒症免疫紊乱作用，从而改善临床疗效。%Objective To assess the efficacy of Shengfu injection (SFI) in treatment of severe sepsis and its effect on im-mune function of patients. Methods Sixty- eight patients with severe sepsis were randomly divided into two groups, 36 patients were treated with Shengfu (SFI group) and conventional therapy and 32 patients received conventional therapy only (control group). The acute physiology and chronic health evaluation II (APACHE II) score and Marshal score were evaluated. The serum levels of interleukins (IL- 6, IL- 10), C- reactive protein, NK cell, CD3+, CD4+, CD8+ T celland monocyte human leukocyte anti-gen- DR (HLA- DR) before and 3, 7 d after treatment were measured. Results There were no significant differences in APACHE II and Marshal scores, serum IL- 6 and IL- 10 levels between two groups before treatment (P>0.05). Before treatment serum IL- 6, IL- 10 and CRP in both groups were significantly higher, and the CD3+, CD4+, CD8+ T cells, NK cells and HLA- DR level were all significantly lower than those of healthy controls (al P<0.05). Compared with the control group, the APACHE II and Mar-shall scores and serum IL- 6, CRP levels in the SFI group were significantly decreased at d7 after treatment, while the CD3 +, CD4+, CD8 +T cells were significantly increased (P<0.05). Conclusion Shengfu injection can improve the therapeutic efficacy of severe sepsis, which may be associated with its effect on regulation of immune function in patients.
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