血毒清治疗脓毒症相关性脑病的效果

Effect of Xueduqing combined with conventional western medicine on treatment of patients with sepsis-associated encephalopathy

  • 摘要: 目的 观察血毒清治疗脓毒症相关性脑病(SAE)对患者脑损伤因子及感染性炎症标志物的影响。方法 选取2016年5月-2019年8月胜利油田中心医院SAE患者72例,以简单随机化法分为试验组(n=36)、对照组(n=36)。对照组予以常规西医治疗,试验组在对照组基础上联合血毒清治疗,均治疗7 d。对比两组疗效与治疗前、治疗7 d后病情严重程度评分(APACHEⅡ)、格拉斯哥昏迷量表(GCS)、血清脑损伤因子S100β、神经元特异性烯醇化酶(NSE)、感染性炎症标志物降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)、T淋巴细胞亚群(CD8+、CD4+、CD4+/CD8+)水平,并统计两组28 d病死率。结果 试验组治疗7 d后总有效率91.67%高于对照组72.22%(P<0.05);两组治疗7 d后APACHEⅡ评分与血清S100β、NSE、PCT、CRP、WBC、CD8+水平较治疗前下降,且试验组低于对照组,GCS评分与血清CD4+、CD4+/CD8+水平较治疗前增高,且试验组高于对照组(P<0.05);试验组28 d病死率19.44%低于对照组41.67%(P<0.05)。结论 应用血毒清联合常规西医治疗SAE患者可提升疗效,减轻病情与昏迷程度,降低脑损伤因子及感染性炎症标志物表达,改善免疫功能,降低病死率。

     

    Abstract: OBJECTIVE To observe the effects of Xueduqing combined with conventional western medicine on brain injury factors and infectious inflammatory markers in patients with sepsis-associated encephalopathy(SAE). METHODS A total of 72 SAE patients in Shengli Oilfield Central Hospital from May 2016 to Aug. 2019 were recruited and divided into the observation group(n=36) and control group(n=36) by simple randomization. The control group was treated with conventional western medicine, and the observation group was treated with Xueduqing on the basis of the control group. All patients were treated for 7 days. Levels of severity score(APACHEⅡ), coma score(GCS), serum brain injury factors including S100β, neuron-specific enolase(NSE), markers of infectious inflammation such as procalcitonin(PCT), C-reactive protein(CRP), white blood cell count(WBC) and T lymphocyte subsets(CD8+, CD4+, CD4+/CD8+) before and 7 days after the treatment in the two groups were compared, and the 28-day mortality rate in the two groups was calculated. RESULTS After the treatment for 7 days, the total effective rate was 91.67%,which was significantly higher than that in the control group(72.22%)(P<0.05). The APACHEⅡ score and serum levels of S100β, NSE, PCT, CRP, WBC and CD8+ in two groups decreased after 7 days of treatment, and the observation group was significantly lower than that in the control group; GCS score and serum CD4+, CD4+/CD8+ levels were significantly higher after the treatment than before the treatment, and the observation group was significantly higher than that in the control group(P<0.05). The 28-day mortality rate in the observation group was 19.44%, which was significantly lower than that in the control group of 41.67%(P<0.05). CONCLUSION The application of Xueduqing combined with conventional western medicine in the treatment of SAE patients can improve the curative effect and alleviate the degree of illness and coma by reducing the expression of brain injury factors and infectious inflammatory markers, so as to improve immune function and reduce mortality.

     

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