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参附注射液治疗严重脓毒症的临床疗效及其对血清白细胞介素-6和白细胞介素-10水平的影响

[Clinical efficacy of shenfu injection in treating severe sepsis and its effects on serum levels of interleukin-6 and interleukin-10].

作者信息

Qiu Ze-Liang, Ye Yi-Ping, Zhang Ning

机构信息

Department of Intensive Care Unit, Sixth Affiliated Hospital of Wenzhou Medical College, Zhejiang 323000.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Mar;32(3):348-51.

Abstract

OBJECTIVE

To observe the therapeutic efficacy of Shenfu Injection (SFI) on patients with severe sepsis and its effects on serum levels of interleukin-6 (IL-6) and interleukin-10 (IL-10).

METHODS

Sixty-eight patients with severe sepsis were randomly assigned to the SFI group (36 cases, treated by SFI + routine therapy) and the control group (32 cases, treated by routine therapy). The acute physiology and chronic health evaluation II (APACHE II) score and Marshall score were observed before treatment, 3 and 7days after treatment. The therapeutic efficacy was assessed, and the 28th-day mortality rates were compared. The serum levels of IL-6 and IL-10 were determined by enzyme-labeled immunosorbent assay (ELISA) before and after treatment. C-reactive protein (CRP) was determined by immunoturbidimetric assay.

RESULTS

There was no significant difference in the APACHE II score, Marshall score, IL-6, IL-10, or CRP between the two groups before treatment (P>0.05). APACHE II score and Marshall score of all patients decreased after treatment, with more obvious decrease shown in the SFI group (P<0.05). The mortality rate in the SFI group and the control group was 25.0% (9/36) and 37.5% (12/32) respectively, with no significant difference shown between the two groups (P>0.05). The serum levels of IL-6 and CRP obviously decreased after 7 days of treatment (P<0.05). But more decrement was shown in the SFI group, showing significant difference when compared with the control group (P<0.05). There was no significant difference in the serum IL-10 level between the two groups before and after treatment (P>0.05).

CONCLUSION

SFI could lower the serum IL-6 level, regulate the equilibrium of proinflammatory factors and anti-inflammatory cytokines in severe sepsis patients, thus playing a role in improving the therapeutic efficacy.

摘要

目的

观察参附注射液(SFI)对严重脓毒症患者的治疗效果及其对血清白细胞介素-6(IL-6)和白细胞介素-10(IL-10)水平的影响。

方法

将68例严重脓毒症患者随机分为参附注射液组(36例,采用参附注射液+常规治疗)和对照组(32例,采用常规治疗)。观察治疗前、治疗后3天和7天的急性生理与慢性健康状况评分系统II(APACHE II)评分和马歇尔评分。评估治疗效果,并比较第28天的死亡率。采用酶联免疫吸附测定(ELISA)法测定治疗前后血清IL-6和IL-10水平。采用免疫比浊法测定C反应蛋白(CRP)。

结果

治疗前两组患者的APACHE II评分、马歇尔评分、IL-6、IL-10或CRP比较,差异均无统计学意义(P>0.05)。所有患者治疗后的APACHE II评分和马歇尔评分均降低,参附注射液组降低更明显(P<0.05)。参附注射液组和对照组的死亡率分别为25.0%(9/36)和37.5%(12/32),两组比较差异无统计学意义(P>0.05)。治疗7天后,血清IL-6和CRP水平明显降低(P<0.05)。但参附注射液组降低更明显,与对照组比较差异有统计学意义(P<0.05)。治疗前后两组血清IL-10水平比较,差异无统计学意义(P>0.05)。

结论

参附注射液可降低严重脓毒症患者血清IL-6水平,调节促炎因子与抗炎细胞因子平衡,从而发挥改善治疗效果的作用。

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