| 张淑文,任爱民,张丽霞,王红,毕铭华,李昂,次秀丽,王彦,齐文杰,王宝恩.感染性多脏器功能不全综合征中西医结合诊治的研究[J].中国中西医结合杂志,2001,(2):85-89 |
| 感染性多脏器功能不全综合征中西医结合诊治的研究 |
| Study on Diɑgnosis ɑnd Treɑtment of Infectious Multiple Organ Dysfunction Syndrome by Integrated Traditional Chinese and Western Medicine |
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| DOI： |
| 中文关键词: 感染 多脏器功能不全综合征 多脏衰 内毒素 中医证型 |
| 英文关键词:infection multiple organ dysfunction syndrome multiple system and organ failure endotoxin TCM Syndrome type |
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| 摘要点击次数: 1267 |
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| 中文摘要: |
| 目的 :探讨感染性多脏器功能不全综合征 (MODS) /多脏衰 (MSOF)的中西医结合诊治方法 ,以提高本症抢救成功率。方法 :对急性感染并发MODS/MSOF住院患者 2 2 5例 ,进行原发疾病、并发症等的西医诊断和证型的中医辨证诊断 ,据此在全面西医西药治疗的基础上 ,应用中药以中西医结合方法治疗 ,并进行临床观察和中药治疗作用的机理研究。结果 :止于 1998年底共救治感染性MODS患者 2 2 5例 ,抢救成功 161例 ,死亡 64例 ,病死率 2 8 4 % ;其中MSOF 140例 ,死亡 58例 ,病死率为 4 1 4 % ,应用美国KnausWA教授MSOF诊断标准 ,本组符合者 10 6例 ,抢救成功 52例 ,死亡 54例 ,病死率为 50 9%。结论 :应用中西医结合方法治疗本综合征 ,疗效显著提高 ,在于中药可改善患者的血流动力学、血液流变学、甲襞微循环障碍 ;影响细胞因子、炎症介质水平 ,从而减轻全身性炎症反应 ,并可减轻胃肠运动功能的受抑制状态、肠道菌群失调及防治肠道细菌、内毒素移位 ;抗氧化保护细胞作用 |
| 英文摘要: |
| Objective: To explore the diagnostic and therapeutic approach of integrated traditional Chinese and western medicine (TCM WM) on infectious multiple organ dysfunction syndrome/multiple system and organ failure (MODS/MSOF) for elevating the successful rate of rescuing the patients. Methods: Diagnosis with western medicine and Syndrome Differentiation of TCM in 225 in patients of acute infectious disease complicated with MODS/MSOF were conducted, and TCM treatment, based on western medical comprehensive treatment, was given to observe the effect and explore the mechanism of the TCM WM therapy. Results: Up to the end of 1998, 161 cases of the 225 cases were successfully cured and 64 died, the mortality being 28.4%. Among them, 58 out of 140 cases of MSOF died, the mortality was accounted for 41.4%. In 106 cases conformed to the diagnostic criteria of MSOF proposed by Professor Knaus WA, USA, 52 cases were cured successfully and 54 died, the mortality being 50.9%. Conclusion: TCM WM treatment could elevate the therapeutic effect in treating MODS, the mechanism might be through improving the hemodynamic and hemorrheologic condition of patients to relieve nail fold microcirculation disorder; influencing the levels of cytokine and inflammatory mediator, so as to alleviate the systemic inflammatory reaction, it might also abate the inhibited condition of gastro intestinal motility, alleviate the intestinal flora imbalance, prevent intestinal bacteria and endotoxin malposition, and protect cells from peroxidation. |
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