目的 探讨参芪扶正注射液联合氢化可的松注射液治疗脓毒症的临床疗效。方法 选取2019年8月-2021年9月在漯河市中心医院就诊的90例脓毒症患者,按照随机数字表法将90例患者分为对照组和治疗组,每组各45例。对照组持续泵入氢化可的松注射液,100 mg/次,1次/8 h。治疗组在对照组基础上静脉滴注参芪扶正注射液,250 mL/次,1次/d。两组在治疗7 d后统计疗效。观察两组的临床疗效,比较两组的急性生理学及慢性健康状况评分系统(APACHE Ⅱ)评分、复苏情况以及血清中C反应蛋白(CRP)、白细胞介素-18(IL-18)、基质金属蛋白酶-1(ESM-1水平。结果 治疗后,治疗组的总有效率(88.89%)明显高于对照组(71.11%)(P<0.05)。治疗后,两组的APACHE Ⅱ评分较治疗前显著降低(P<0.05),且治疗组APACHE Ⅱ评分明显低于对照组(P<0.05)。治疗后,治疗组的液体复苏剂量、退热时间、血压恢复时间、完成复苏时间均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的血清CRP、IL-18、ESM-1水平显著减低(P<0.05);治疗组的血清CRP、IL-18、ESM-1水平比对照组低(P<0.05)。结论 参芪扶正注射液联合氢化可的松注射液能提高脓毒症的疗效,控制病情发展,促使患者复苏,降低炎症反应,治疗安全性良好。

Objective To investigate the clinical efficacy of Shenqi Fuzheng Injection combined with Hydrocortisone Injection in treatment of sepsis. Methods Patients (90 cases) with sepsis in Luohe Central Hospital from August 2019 to September 2021 were divided into control and treatment groups according to the random number table method, and each group had 45 cases. Patients in the control group were continuous pumping administered with Hydrocortisone Injection, 100 mg/time, once every 8 h. Patients in the treatment group were iv administered with Shenqi Fuzheng Injection on the basis of the control group, 250 mL/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and the APACHE Ⅱ score, resuscitation, and the serum levels of CRP, IL-18, and ESM-1 in two groups were compared. Results After treatment, the total efficacies of the treatment group (88.89%) was significantly higher than that of the control group (71.11%) (P < 0.05). After treatment, the APACHE Ⅱ score of two groups was significantly lower than that before treatment (P < 0.05), and the APACHE Ⅱ score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the fluid resuscitation dose, antipyretic time, blood pressure recovery time, and complete resuscitation time in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of CRP, IL-18, and ESM-1 in two groups were significantly decreased (P < 0.05), and the serum levels of CRP, IL-18, and ESM-1 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Shenqi Fuzheng Injection combined with Hydrocortisone Injection have the curative effect of sepsis, and can control the development of the disease, promote the recovery of patients, and reduce inflammatory reaction with good safety.

R976

河南省医学科技攻关项目（LHGJ20191408）