目的 研究参附注射液联合乌司他丁治疗脓毒血症的临床疗效。方法 选取2012年5月—2015年1月辽宁省肿瘤医院收治的脓毒血症患者120例,随机分为对照组和治疗组,每组各60例。对照组在基础治疗基础上静脉滴注注射用乌司他丁,溶于500 mL生理盐水,1×10⁵ U/次,2次/d。治疗组在对照组基础上静脉滴注参附注射液,溶于250 mL 5%葡萄糖,100 mL/次,1次/d。两组均连续治疗治疗7 d。比较两组患者的死亡率,同时比较两组治疗前后急性生理与慢性健康Ⅱ(APACHEⅡ)评分、CD³⁺、CD⁴⁺百分率、CD⁴⁺/CD⁸⁺比值以及血清肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)水平。结果 治疗后,对照组死亡率为40.0%,治疗组死亡率为18.3%,两组比较差异具有统计学意义(P< 0.05)。治疗后两组APACHEⅡ评分、TNF-α、IL-10均显著降低,CD³⁺、CD⁴⁺水平、CD⁴⁺/CD⁸⁺比值均显著升高,同组治疗前后差异具有统计学意义(P< 0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P< 0.05)。结论 参附注射液联合乌司他丁治疗脓毒血症具有较好的疗效,能够有效降低炎症因子水平,改善免疫功能,值得在临床上进一步推广和应用。

Objective To explore the clinical effects of Shenfu Injection combined with ulinastatin in treatment of sepsis. Methods Patients (120 cases) with sepsis in Liaoning Cancer Hospital and Institute from May 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were iv administered with Ulinastatin for injection on the basis of foundation treatment, 1×10⁵ U/time added into 500 mL normal saline, twice daily. The patients in the treatment group were iv administered with Shenfu Injection on the basis of the control group, 100 mL/time added into 5% glucose solution, once daily. The patients in two groups were treated for 7 d. After treatment, mortality in two groups were compared, and APACHEⅡ scores, CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺, TNF-α, and IL-10 in two groups before and after treatment were compared. Results After treatment, the mortality in control group was 40.0%, and that in treatment group was 18.3%, and there were differences between two groups (P < 0.05). APACHEⅡ scores, TNF-α, and IL-10 in two groups were significantly decreased, and CD³⁺, CD⁴⁺, and CD⁴⁺/CD⁸⁺ were significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observed indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shenfu Injection combined with ulinastatin has curative effect in treatment of sepsis, and can effectively reduce the inflammatory factor levels, also can improve the immune function, which is worthy of further promotion and application in clinical practice.