Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction

Yan DONG; Xu DONG; Pan-pan YU; Bao-zhu SHI

doi:10.13422/j.cnki.syfjx.20191132

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Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 14, Pages: 125-129(2019)
- 作者机构：
  
  1.河北省中医院，石家庄　 050011；
  2.河北医科大学，石家庄　 050011
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191132
  CLC： R289; R54; R541; R543
- Published：20 July 2019，
  
  Published Online：14 January 2019，
  
  Received：06 November 2018，
- 稿件说明：
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Yan DONG, Xu DONG, Pan-pan YU, et al. Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction. [J]. Chinese Journal of Experimental Traditional Medical Formulae 25(14):125-129(2019)
DOI：

Yan DONG, Xu DONG, Pan-pan YU, et al. Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction. [J]. Chinese Journal of Experimental Traditional Medical Formulae 25(14):125-129(2019) DOI： 10.13422/j.cnki.syfjx.20191132.

摘要

目的：

观察升麻鳖甲汤联合参附汤治疗脓毒症心功能障碍(SIMD)的临床疗效及对炎症反应的控制效果。

方法：

将88例符合要求的SIMD患者随机分为对照组和观察组各44例。对照组给予脓毒症的集束化治疗方案，包括给予液体复苏，抗感染治疗，血管活性药物等综合治疗方案。观察组在对照组治疗的基础上内服升麻鳖甲汤联合参附汤加减，1剂/d。两组疗程均为连续治疗7 d。检测治疗前后肌钙蛋白(cTnI)，肌酸激酶同工酶(CK-MB)，

末端脑钠肤前体(NT-proBNP)，降钙素原(PCT)，超敏C-反应蛋白(hs-CRP)，肿瘤坏死因子-

(TNF-

)和白细胞介素-6(IL-6)水平；进行治疗前后心脏彩色多普勒超声仪检查，记录左室射血分数(LVEF)，二尖瓣舒张早期的血流速度与心房收缩期峰值血流速度比值(E/A)和每搏输出量(SV)；检测治疗前后血乳酸(LAC)水平，并计算乳酸清除率(LCR)；进行治疗前后脓毒症相关序贯器官衰竭评分(SOFA)，急性生理及慢性健康评分(APACHEⅡ)和中医证候评分。

结果：

治疗后观察组患者的cTnI，NT-ProBNP，CK-MB水平均明显低于对照组(

0.01)；观察组患者LVEF，E/A和SV均高于对照组(

0.01)；观察组患者血清Hs-CRP，IL-6，PCT和TNF-

水平均低于对照组(

0.01)；治疗后观察组患者的LAC水平低于对照组(

0.01)，LCR高于对照组(

0.01)；观察组SOFA，APACHEⅡ和中医证候评分均低于对照组(

0.01)。

结论：

在西医综合治疗的基础上，升麻鳖甲汤联合参附汤治疗SIMD，能控制炎症反应，减轻心肌抑制和心肌损伤，对改善心功能起到保护作用，有助于SIMD患者临床症状的减轻。

Abstract

Objective:

To observe clinical efficacy of Shengma Biejia Tang combined with Shenfutang on sepsis-induced myocardial dysfunction (SIMD) and study the controlling effect on inflammatory reaction.

Method:

Eighty-eight patients with SIMD were randomly divided into control group (44 cases) and observation group (44 cases) by random number table. Patients in control group received the early bundle therapy of sepsis

including fluid resuscitation

anti-infection treatment and vasoactive drugs. In addition to the therapy of control group

patients in observation were also given Shengma Biejia Tang combined with Shenfutang

1 dose/day. And a course of treatment was 7 days. Before and after treatment

levels of troponin (cTnI)

creatine kinase isoenzyme (CK-MB)

terminal brain natriuretic precursor (NT-proBNP)

calcitonin (PCT)

hypersensitivity C reactive protein (hs-CRP)

tumor necrosis factor-

(TNF-

)

interleukins-6 (IL-6) and blood lactic acid (LAC) were detected. And color Doppler ultrasound examination of the heart was performed to record left ventricular ejection fraction (LVEF)

blood flow velocity of early mitral valve diastole and ratio of blood flow velocity at atrial systolic peak (E/A) and stroke volume (SV). And lactate clearance rate (LCR) was calculated. And sequential (sepsis-related) organ failure assessment (SOFA)

acute physiology and chronic health (APACHEⅡ) and traditional Chinese medicine(TCM)syndromes were scored.

Result:

After treatment

levels of cTnI

NT-ProBNP

CK-MB

Hs-CRP

IL-6

PCT

TNF-

and LAC in observation group were lower than those in control group (

0.01)

and levels of LVEF

E/A

SV and LCR were higher than those in observation group (

0.01). And scores of SOFA

APACHEⅡ and traditional Chinese inedicine(TCM) syndromes were lower than those in control group (

0.01).

Conclusion:

In addition to the integrated western medicine

Shengma Biejia Tang combined with Shenfutang can control inflammatory reaction

relieve myocardial inhibition and myocardial damage

and protect and improve heart function

and alleviate the symptoms.

关键词

脓毒症心功能障碍升麻鳖甲汤参附汤温阳化瘀解毒炎症反应

Keywords

sepsis-induced myocardial dysfunctionShengma Biejia TangShenfutangyang warming stasis dissipating and detoxifyinginflammatory reaction

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