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参附注射液联合早期目标导向治疗对感染性休克患者器官功能及预后的影响

Effect of the Shenfu Injection Combined with Early Goal-Directed Therapy on Organ Functions and Outcomes of Septic Shock Patients.

作者信息

Li Mao-Qin, Pan Cui-Gai, Wang Xiao-Meng, Mo Xun, Shi Zai-Xiang, Xu Ji-Yuan, Xu Yan-Jun, Han Guan-Jie

机构信息

Department of Critical Care Medicine, Central Hospital of Xuzhou, 199 Jie fang Road, Xuzhou, 221009, Jiangsu, China.

出版信息

Cell Biochem Biophys. 2015 Jul;72(3):807-12. doi: 10.1007/s12013-015-0537-4.

DOI:10.1007/s12013-015-0537-4
PMID:25680826
Abstract

Shenfu injection (SFI) derived from traditional Chinese medicine has been widely used in cardiovascular diseases. The objective of this study was to determine the effect of SFI and conventional early goal-directed therapy (EGDT) on organ functions and outcomes of septic shock patients. For this purpose, a total of 45 septic shock patients were randomly divided into control group A (24 patients on EGDT) and experimental group B (21 patients on SFI + EGDT). SFI was administered (100@20 mL/h) twice daily. Hemodynamic status, lactic acid, and vasoactive drug use were observed before and after treatment. Other indicators included ventilator weaning time, ICU stay time, free of organ failure time, and 28-day hospital mortality. Regarding experimental group, compared with controls, BUN/creatinine decreased significantly at 3, 5, and 7 days while PaO2/FiO2 increased at 1 and 3 days (P < 0.05). APACHE-II and SOFA scores decreased in both groups at 3, 5, and 7 days (P < 0.05), whereas SOFA scores improved more in experimental group as compared with controls. Ventilator weaning time and ICU stay were significantly shorter in experimental group as compared with controls. In both groups, mean arterial pressure/systemic vascular resistance index post-treatment levels increased and lactic acid decreased at 6, 12, 24, 48, and 72 h (P < 0.05). Heart rate decreased at 24, 48, and 72 h (P < 0.05); while gamma-glutamyl transpeptidase and glutamate oxaloacetate transaminase levels increased at 1 day and 1 and 3 days, respectively (P < 0.05). Combined use of SFI and EGDT can improve hemodynamics, reduce the damage to vital organs, and shorten ventilation and ICU stay times in septic shock patients.

摘要

源自中药的参附注射液(SFI)已广泛应用于心血管疾病。本研究的目的是确定参附注射液和传统早期目标导向治疗(EGDT)对感染性休克患者器官功能和预后的影响。为此,将45例感染性休克患者随机分为对照组A(24例接受EGDT)和实验组B(21例接受SFI + EGDT)。参附注射液以100@20 mL/h的速度每日给药两次。观察治疗前后的血流动力学状态、乳酸水平和血管活性药物的使用情况。其他指标包括呼吸机撤机时间、ICU住院时间、无器官衰竭时间和28天医院死亡率。对于实验组,与对照组相比,BUN/肌酐在第3、5和7天显著降低,而PaO2/FiO2在第1和3天升高(P < 0.05)。两组的APACHE-II和SOFA评分在第3、5和7天均降低(P < 0.05),而实验组的SOFA评分改善程度高于对照组。与对照组相比,实验组的呼吸机撤机时间和ICU住院时间明显缩短。两组治疗后平均动脉压/全身血管阻力指数水平在6、12、24、48和72小时升高,乳酸水平降低(P < 0.05)。心率在24、48和72小时降低(P < 0.05);而γ-谷氨酰转肽酶和谷氨酸草酰乙酸转氨酶水平分别在第1天和第1和3天升高(P < 0.05)。参附注射液与EGDT联合使用可改善血流动力学,减少对重要器官的损害,并缩短感染性休克患者的通气时间和ICU住院时间。

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