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目的:观察中药干预治疗创伤后脓毒症所致多器官功能障碍综合征(MODS)患者的疗效及机制研究。方法:60例患者随机平均分为治疗组和对照组。治疗组采用通腑净化汤和西医常规治疗,对照组仅采用西医常规治疗。观察治疗前和治疗后第3,7天血小板压积(PCT),肿瘤坏死因子-α(TNF-α),白细胞介素-1(IL-1)、IL-6变化,以及治疗前与治疗后第1,3,7天多器官功能障碍相关指标改善情况。结果:治疗后3,7 d,治疗组PCT,TNF-α,IL-6及IL-10变化与对照组比较,有显著性差异(P<0.05)。疗后7 d,治疗组与对照组对比,平均动脉压(MAP)、氧合指数(PaO2/FiO2)、尿量、血肌酐(SCr)、血浆总胆红素(TBIL)、活化部分凝血活酶时间(APTT)、PT国际标准化比率(INR)、格拉斯哥评分(GCS)、腹内压改善明显(P<0.05)。结论:通腑净化汤联合西医常规治疗MODS,能有效清除内毒素,减轻炎症反应,改善各器官脏器功能,达到多脏器保护的目的。
Objective: To observe the efficacy and mechanism of traditional Chinese medicine (TCM) intervention in the treatment of post-traumatic sepsis-induced multiple organ dysfunction syndrome (MODS). Methods: 60 patients were randomly divided into treatment group and control group. The treatment group Tongfu Purification Decoction and Western conventional treatment, the control group only conventional treatment of Western medicine. The changes of platelet pressure (PCT), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1) and IL-6 on the 3rd and 7th day after treatment were observed before treatment and after treatment After 1,3,7 days after multiple organ dysfunction-related indicators to improve the situation. Results: At 3 and 7 days after treatment, the changes of PCT, TNF-α, IL-6 and IL-10 in the treatment group were significantly different from those in the control group (P <0.05). At 7 days after treatment, the mean arterial pressure (MAP), PaO2 / FiO2, urine volume, serum creatinine (SCr), total serum bilirubin (TBIL) APTT, INR, Glasgow score (GCS) and intra-abdominal pressure were significantly improved (P <0.05). Conclusion: Tongfu Purification Decoction combined with Western medicine routine treatment of MODS can effectively remove endotoxin, reduce inflammation, improve the function of various organs and organs, and achieve the purpose of multiple organ protection.