| 高志凌,俞兴群,杨明,李远思,聂卫群,洪峰,王龙梅,程玲.益气养阴活血法治疗脓毒症应激性高血糖的临床观察[J].,2012,32(10):1336-1339 |
| 益气养阴活血法治疗脓毒症应激性高血糖的临床观察 |
| Clinical Trial of Treating Stress-induced Hyperglycemia Patients with Sepsis by Supplementing Qi, Nourishing Yin, and Promoting Blood Flow |
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| DOI： |
| 中文关键词: 益气养阴活血法 脓毒症 免疫功能 应激性高血糖 参麦注射液 丹参酮ⅡA磺酸钠注射液 |
| 英文关键词:supplementing qi, nourishing yin, and promoting blood flow method sepsis immune function stress-induced hyperglycemia Shenmai Injection Sulfotanshinone Sodium Injection |
| 基金项目:安徽中医学院临床科学研究基金资助项目(No.2010LC-001A) |
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| 中文摘要: |
| 目的探讨益气养阴活血法对脓毒症应激性高血糖患者血清C反应蛋白(C-reactive protein,CRP)、TNF-α、IL-1、IL-6水平及外周血单核细胞人白细胞抗原(human leukocyte antigen,HLA)-DR表达的影响。方法采用前瞻性随机对照研究方法 ,选择脓毒症应激性高血糖患者85例,随机分为试验组(45例)和对照组(40例),两组均给予常规抗感染、营养支持和胰岛素泵控制血糖,试验组按益气养阴活血法,加用参麦注射液和丹参酮ⅡA磺酸钠注射液静脉滴注,每天1次,连续7天。ELISA法检测两组患者治疗前及治疗第8天血清CRP、TNF-α、IL-1、IL-6水平及外周血单核细胞HLA-DR表达;比较两组患者胰岛素连续使用时间、胰岛素使用总量、低血糖发生率、APACHEⅡ评分以及住院28天病死率。结果与对照组比较,试验组胰岛素使用总量、胰岛素连续使用时间、低血糖发生率、治疗第8天APACHEⅡ评分以及住院28天病死率均明显下降(P<0.05,P<0.01)。两组患者治疗前血清CRP、TNF-α、IL-1和IL-6水平以及HLA-DR表达比较,差异均无统计学意义(P>0.05);治疗后两组血清CRP、TNF-α、IL-1和IL-6水平较治疗前降低,HLA-DR表达较治疗前升高,差异均有统计学意义(P<0.05),以试验组作用更优(P<0.05,P<0.01)。结论益气养阴活血法配合胰岛素强化治疗能更好地改善脓毒症患者免疫状态,降低应激性高血糖的血糖水平和持续时间,提高生存率,改善预后。 |
| 英文摘要: |
| Objective To investigate the effects of the treatment of supplementing qi, nourishing yin, and promoting blood flow (SQNYPBF) on the serum levels of CRP, TNF-α, IL-1 and IL-6, as well as the expression of HLA-DR in the peripheral monocytes in septic patients suffering from stress-induced hyperglycemia. MethodsIn the prospective randomized controlled study, eighty-five stress-induced hyperglycemia patients with sepsis were randomly assigned to the experimental group (45 cases) and the control group (40 cases). On the basis of routine therapies, including anti-infection, nutrition support, and the glucose control with insulin pump, patients in the experimental group additionally received the treatment of SQNYPBF (They were intravenously dripped with Shenmai Injection and Sulfotanshinone Sodium Injection, once daily, for 7 successive days). The serum levels of CRP, TNF-α, IL-1, and IL- 6 and the HLA-DR expression of the peripheral monocytes were detected using ELISA before treatment and on the 8th day of the treatment. The total dose and the duration of insulin used, the morbidity of hypoglycemia, the APACHE Ⅱ scores, and the mortality within 28-day hospitalization were compared between the two groups. Results The total dose of insulin used, the duration of insulin used, the morbidity of hypoglycemia, the APACHE Ⅱ score on the 8th day of treatment, and the mortality within 28-day hospitalization significantly decreased in the experimental group, when compared with the control group (P<0.05, P<0.01). There was no difference in the expression of HLA-DR, the serum levels of CRP, TNF-α, IL-1, or IL-6 before treatment between the two groups (P>0.05). After treatment the serum levels of CRP, TNF-α, IL-1, and IL-6 significantly decreased (P<0.05) and the expression of HLA-DR significantly increased in the two groups (P<0.05). Better effects were shown in the experimental group (P<0.05, P<0.01). Conclusion SQNYPBF combined intensive insulin therapy could better improve the sepsis patients′ immunity, decrease the plasma glucose level and duration, increase their survival rate, and improve their prognosis. |
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