Huang Zhipeng, Cai Xiaoxin, Lin Yao, Zheng Bojun, Jian Li, Yi Yu, Guang Yang
Dongguan Hospital of Integrated Chinese and Western Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Dongguan 523000, Guangdong, China.
Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China.
Evid Based Complement Alternat Med. 2021 Oct 29;2021:8475727. doi: 10.1155/2021/8475727. eCollection 2021.
A specific and efficacious method for treatment of pneumonia-derived sepsis is lacking. Chengqi decoction has been used for treatment of pneumonia-derived sepsis, but a clinical trial on patients with pneumonia-derived sepsis is lacking, a gap in the literature that we sought to fill. . 282 patients with pneumonia-derived sepsis admitted to the intensive care unit of our hospital were selected. They were divided into the treatment group (141 cases) and control group (141 cases). Both groups underwent conventional treatment, but Chengqi decoction (in the form of enema) was given to the treatment group. Mortality, morbidity (abdominal distension and gastrointestinal bleeding), duration of antibiotic use, and use of vasoactive agents were documented 28 days after the drug was used.
The treatment group reduced mortality and morbidity (abdominal distension) ( < 0.05). After adjustment for significant covariates, 28-day survival was similar for the whole group (hazard ratio (HR): 0.48; 95% confidence interval (CI): 0.23-0.97; =0.037), for the subgroup ( = 120) with Acute Physiology and Chronic Health Evaluation II score ≥25 (HR: 0.180; 95% CI: 0.032-0.332; =0.039) and for the subgroup ( = 66) with N-terminal B-type natriuretic peptide <1800 (0.059, 0.004-0.979, and 0.019). There was no difference between the two groups for the duration of antibiotic use, major bleeding, or use of vasoactive drugs.
Chengqi decoction improved 28-day survival and reduced the prevalence of abdominal distension in patients with pneumonia-derived sepsis.
目前缺乏治疗肺炎相关性脓毒症的特异性有效方法。承气汤已被用于治疗肺炎相关性脓毒症，但缺乏针对肺炎相关性脓毒症患者的临床试验，这是我们试图填补的文献空白。选取我院重症监护病房收治的282例肺炎相关性脓毒症患者，分为治疗组（141例）和对照组（141例）。两组均接受常规治疗，但治疗组给予承气汤（灌肠剂型）。用药28天后记录死亡率、发病率（腹胀和胃肠道出血）、抗生素使用时间及血管活性药物使用情况。
治疗组降低了死亡率和发病率（腹胀）（P<0.05）。在对显著协变量进行调整后，全组28天生存率相似（风险比（HR）：0.48；95%置信区间（CI）：0.23 - 0.97；P = 0.037），急性生理与慢性健康状况评分II≥25的亚组（n = 120）（HR：0.180；95%CI：0.032 - 0.332；P = 0.039）以及N末端B型利钠肽<1800的亚组（n = 66）（P = 0.059，0.004 - 0.979，P = 0.019）。两组在抗生素使用时间、大出血或血管活性药物使用方面无差异。
承气汤可提高肺炎相关性脓毒症患者的28天生存率，并降低腹胀的发生率。
