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河北北方学院 附属第一医院,河北 张家口 075000
邢静,硕士,主治医师,从事小儿内科感染性疾病临床诊疗工作, E-mail:xj15530396643@163.com
收稿日期:2020-12-24,
网络出版日期:2021-01-10,
纸质出版日期:2021-07-05
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邢静,卢艳辉,王艳飞等.清开灵注射液辅助治疗小儿脓毒症毒热证的临床疗效[J].中国实验方剂学杂志,2021,27(13):78-82.
XING Jing,LU Yan-hui,WANG Yan-fei,et al.Clinical Research of Qingkailing Injection in Adjuvant Treatment of Sepsis and Heat Syndrome in Children[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):78-82.
邢静,卢艳辉,王艳飞等.清开灵注射液辅助治疗小儿脓毒症毒热证的临床疗效[J].中国实验方剂学杂志,2021,27(13):78-82. DOI: 10.13422/j.cnki.syfjx.20210533.
XING Jing,LU Yan-hui,WANG Yan-fei,et al.Clinical Research of Qingkailing Injection in Adjuvant Treatment of Sepsis and Heat Syndrome in Children[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):78-82. DOI: 10.13422/j.cnki.syfjx.20210533.
目的
2
评价清开灵注射液辅助治疗小儿脓毒症毒热证的临床疗效和抗炎、抗凝及心脏损伤保护作用研究。
方法
2
按随机数字表法将80例患儿分为对照组和观察组各40例。两组均给予液体复苏、抗感染、抗炎、抗凝、血管活性药物及重要器官功能保护等综合治疗措施。观察组采用清开灵注射液,每次5~10 mL,稀释后静脉滴注,1次/d。两组疗程均为5 d。进行治疗前后儿童年龄适应性序贯器官衰竭评分(qSOFA),小儿危重症评分(PCIS)和急性生理及慢性健康评分Ⅱ(APACHEⅡ);检测治疗前后降钙素原(PCT),血清淀粉样蛋白A(SAA),肝素结合蛋白(HBP),肿瘤坏死因子-
α
(TNF-
α
),超敏C反应蛋白(hs-CRP),白细胞介素-6(IL-6),IL-10,N末端脑钠肽前体(NT-proBNP),高敏心肌肌钙蛋白T(hs-cTnT)水平,心肌肌钙蛋I(cTnI),肌酸激酶同工酶(CK-MB),
D
-二聚体(
D
-D),纤维蛋白原(FIB)和抗凝血酶Ⅲ(AT-Ⅲ)水平。
结果
2
治疗后观察组APACHEⅡ和qSOFA评分均低于对照组(
P
<
0.05),PCIS评分高于对照组(
P
<
0.05);观察组PCT,SAA,HBP,TNF-
α
,hs-CRP和IL-6水平均低于对照组(
P
<
0.01),IL-10水平高于对照组(
P
<
0.01);观察组NT-proBNP,hs-cTnT,cTnI和CK-MB水平均低于对照组(
P
<
0.01);观察组
D
-D,FIB水平均低于对照组(
P
<
0.01),AT-Ⅲ活性高于对照组(
P
<
0.01)。
结论
2
清开灵注射液辅助用于脓毒症毒热证患儿,可起到抗炎、抗凝、减轻感染和心肌损伤等作用,从而起到减轻病情程度,改善预后的效果。
Objective
2
To evaluate the clinical efficacy of Qingkailing injection in the treatment of children with sepsis and heat syndrome, and investigate its anti-inflammatory, anticoagulant and protective effects.
Method
2
Eighty patients were randomly divided into control group and observation group with forty cases in each group according to the number table. Both groups received comprehensive treatment measures such as fluid resuscitation, anti-infection, anti-inflammatory, anticoagulation, vasoactive drugs, and protection of vital organ functions. While patients in observation group additionally took Qingkailing injection, 5-10 mL each time, intravenous drip after dilution, 1 time/day. Treatment course was five days in both groups. Before and after treatment, the scores of quick sequential organ failure assessment (qSOFA), pediatric critical illness score (PCIS) and acute physiology and chronic health evalution Ⅱ (APACHEⅡ) were graded; procalcitonin (PCT), serum amyloid A protein (SAA) before and after treatment, heparin-binding protein (HBP), tumor necrosis factor-
α
(TNF-
α
), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), IL-10, N-terminal brain sodium Peptide precursor (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT) level, cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB),
D
-dimer (
D-
D ), fibrinogen (FIB) and antithrombin Ⅲ (AT-Ⅲ) levels were detected.
Result
2
The APACHEⅡ and qSOFA scores in the observation group were lower than those in the control group (
P
<
0.05), while the PCIS score was higher than that in the control group (
P
<
0.05). The levels of PCT, SAA,HBP,TNF-
α
, hs-CRP and IL-6 in the observation group were lower than those in the control group (
P
<
0.01), while the IL-10 level was higher than that in the control group (
P
<
0.01). The levels of NT-proBNP, hs-cTnT, cTnI, CK-MB,
D
-D and FIB in the observation group were lower than those in the control group (
P
<
0.01), while the AT-Ⅲ activity was higher than that in the control group (
P
<
0.01).
Conclusion
2
Qingkailing injection as the adjuvant therapy in children with sepsis and fever syndrome, can play the role of anti-inflammatory, anticoagulant, reducing infection and myocardial damage, thereby reducing the severity of the disease and improving the prognosis.
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