目的 觀察參附注射液改善膿毒癥休克的臨床療效。方法 選取2014年10月—2016年3月天津中醫(yī)藥大學(xué)第一附屬醫(yī)院收治的膿毒癥休克患者71例，所有患者按隨機(jī)數(shù)字表法分為對照組（35例）和治療組（36例）。對照組給予積極維持循環(huán)、機(jī)械通氣、控制血糖、鎮(zhèn)靜等治療。治療組在對照組基礎(chǔ)上靜脈滴注參附注射液，100 mL加入5%葡萄糖250 mL中，1次/d。兩組均治療7 d。觀察并比較兩組的中心靜脈血氧飽和度（ScVO₂）、乳酸（Lac）、24 h乳酸清除率、氧輸送量（DO₂）、氧消耗量（VO₂）、氧攝取率（O₂ER%），序貫器官衰竭估計（SOFA）評分、急性生理功能和慢性健康狀況評分系統(tǒng)Ⅱ（APACHEⅡ）評分、重癥監(jiān)護(hù)室（ICU）住院時間和28 d死亡率。結(jié)果 治療后，兩組ScVO₂和Lac均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P< 0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P< 0.05）。治療后，治療組24 h乳酸清除率明顯高于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P< 0.05）。治療后，兩組DO₂水平均明顯上升，同組治療前后比較差異有統(tǒng)計學(xué)意義（P< 0.05），而VO2和O2ER%改善不明顯；且治療組DO₂水平明顯高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P< 0.05）。兩組SOFA評分和APACHEⅡ評分均明顯降低（P< 0.05），同組治療前后比較差異有統(tǒng)計學(xué)意義（P< 0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P< 0.05）。對照組和治療組ICU住院時間比較差異無統(tǒng)計學(xué)意義。對照組和治療組死亡率比較差異無統(tǒng)計學(xué)意義。結(jié)論 參附注射液可改善膿毒癥休克治療，增加氧輸送量，改善組織灌注狀態(tài)，降低SOFA評分和APACHEⅡ評分，具有一定的臨床推廣應(yīng)用價值。

Objective To observe the clinical effect of Shenfu Injection to improve septic shock. Methods Patients (71 cases) with septic shock in First Teaching Hospital of Tianjin University of TCM from October 2014 to March 2016 were randomly divided into the control group (35 cases) and the treatment group (36 cases). Patients in the control group were given routine treatment, including maintaining circulation, mechanical ventilation, blood glucose control, sedation. Patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group, 100 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 7 d. After treatment, ScVO₂, Lac, 24 h lactic acid clearance rate, DO₂, VO₂, O₂ER%, SOFA scores, APACHEⅡ scores, ICU hospitalization time, and 28 d mortality in two groups were compared. Results After treatment, ScVO₂ and Lac in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the 24 h lactic acid clearance rate in the treatment group was higher than that in the control group, and there was difference between two groups (P < 0.05). After treatment, the DO₂ levels in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05), but VO₂ and O₂ER% had no difference. And the DO₂ levels in the treatment group were significantly higher than that in the control group, with significant difference between two groups (P < 0.05). After treatment, SOFA scores and APACHEⅡ scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). There was no difference of ICU hospitalization time and mortality rate between two groups.Conclusion Shenfu Injection can improve septic shock therapy, increase oxygen delivery, improve tissue perfusion, and decrease SOFA scores and APACHEⅡ scores, which has a certain clinical application value.