温肾暖脾通下方对严重脓毒症患者免疫麻痹的影响

发布时间：2017-12-31 02:08

本文关键词：温肾暖脾通下方对严重脓毒症患者免疫麻痹的影响　出处：《中国中医药科技》2017年02期 　论文类型：期刊论文

【摘要】：目的:观察温肾暖脾通下方治疗严重脓毒症患者的临床疗效及其对免疫麻痹的调节作用。方法:60例严重脓毒症患者随机分为2组,每组30例,对照组采用西医常规治疗,观察组在对照组治疗基础上辅以温肾暖脾通下方治疗。观察2组治疗前及治疗第5 d、第10 d APACHEII评分、免疫学相关指标、降钙素原(PCT)的变化;比较2组ICU住院时间以及28 d死亡率。结果:观察组28 d死亡率为16.7%低于对照组之36.7%,但无统计学差异(χ~2=3.068,P=0.080);观察组ICU住院时间为(12.25±8.32)d,明显短于对照组(19.75±12.56)d(t=2.727,P=0.0084);观察组第5 d、第10 dCD_(14)~+单核细胞人白细胞DR抗原(HLA-DR)、T淋巴细胞亚群(CD_4~+、CD_8~+、CD_4~+/CD_8~+)、自然杀伤细胞(NK细胞)、免疫球蛋白IgG、IgM以及PCT等指标的的改善均优于对照组(P0.05,P0.01)。结论:温肾暖脾通下方能增强严重脓毒症患者免疫功能,缩短患者ICU的住院时间,改善预后。
[Abstract]:Objective: to observe the clinical effect of Wenshen warming spleen Tong on severe sepsis and its regulating effect on immune paralysis. Methods: 60 patients with severe sepsis were randomly divided into two groups, 30 cases in each group. The control group was treated with routine western medicine, the observation group was treated with warm kidney and warm spleen decoction on the basis of the control group, and the APACHEII score was observed before treatment and at the 5th day and 10th day after treatment. Changes of immunological parameters, procalcitonin (PCT); Results: the mortality rate of 28 days in the observation group was 16.7% lower than that in the control group (36.7%), but there was no significant difference between the two groups (蠂 2 + 3.068). P0. 080; The hospitalization time of ICU in the observation group was 12.25 卤8.32 days, which was significantly shorter than that in the control group (19.75 卤12.56). In the observation group, on the 5th day and the 10th day, the number of HLA-DRN T lymphocyte subsets of monocyte Dr antigen was 14 ~ +, and CD4 ~ + + CD8 ~ + T lymphocyte subsets of human leukocyte Dr antigen were found in the observation group. The improvement of CD4 / CD8, NK cell, IgGG IgM and PCT were better than that of control group (P0.05). Conclusion: Wenshenhuanpi Tong can enhance the immune function of the patients with severe sepsis, shorten the hospitalization time of the patients with ICU, and improve the prognosis.
【作者单位】：广东省深圳市龙岗区中医院;梅州市残联康复医院中医科;
【分类号】：R459.7
【正文快照】： 脓毒症是危重症患者死亡的首要原因,也是人类十大死亡原因之一[1],以免疫麻痹为主的免疫功能紊乱是严重脓毒症患者死亡的关键因素[2]。增强免疫治疗被国内外学者认为可以改善严重脓毒症患者的预后,提高存活率;而一些中药组方可以增强此类患者的免疫功能、改善预后[3]。本研究

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