目的 研究參附注射液聯(lián)合烏司他丁治療膿毒血癥的臨床療效。方法 選取2012年5月—2015年1月遼寧省腫瘤醫(yī)院收治的膿毒血癥患者120例,隨機(jī)分為對(duì)照組和治療組,每組各60例。對(duì)照組在基礎(chǔ)治療基礎(chǔ)上靜脈滴注注射用烏司他丁,溶于500 mL生理鹽水,1×10⁵ U/次,2次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注參附注射液,溶于250 mL 5%葡萄糖,100 mL/次,1次/d。兩組均連續(xù)治療治療7 d。比較兩組患者的死亡率,同時(shí)比較兩組治療前后急性生理與慢性健康Ⅱ(APACHEⅡ)評(píng)分、CD³⁺、CD⁴⁺百分率、CD⁴⁺/CD⁸⁺比值以及血清腫瘤壞死因子α(TNF-α)、白細(xì)胞介素10(IL-10)水平。結(jié)果 治療后,對(duì)照組死亡率為40.0%,治療組死亡率為18.3%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。治療后兩組APACHEⅡ評(píng)分、TNF-α、IL-10均顯著降低,CD³⁺、CD⁴⁺水平、CD⁴⁺/CD⁸⁺比值均顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。結(jié)論 參附注射液聯(lián)合烏司他丁治療膿毒血癥具有較好的療效,能夠有效降低炎癥因子水平,改善免疫功能,值得在臨床上進(jìn)一步推廣和應(yīng)用。

Objective To explore the clinical effects of Shenfu Injection combined with ulinastatin in treatment of sepsis. Methods Patients (120 cases) with sepsis in Liaoning Cancer Hospital and Institute from May 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were iv administered with Ulinastatin for injection on the basis of foundation treatment, 1×10⁵ U/time added into 500 mL normal saline, twice daily. The patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group, 100 mL/time added into 5% glucose solution, once daily. The patients in two groups were treated for 7 d. After treatment, mortality in two groups were compared, and APACHEⅡ scores, CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺, TNF-α, and IL-10 in two groups before and after treatment were compared. Results After treatment, the mortality in control group was 40.0%, and that in treatment group was 18.3%, and there were differences between two groups (P < 0.05). APACHEⅡ scores, TNF-α, and IL-10 in two groups were significantly decreased, and CD³⁺, CD⁴⁺, and CD⁴⁺/CD⁸⁺ were significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observed indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shenfu Injection combined with ulinastatin has curative effect in treatment of sepsis, and can effectively reduce the inflammatory factor levels, also can improve the immune function, which is worthy of further promotion and application in clinical practice.