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目的评估中药升降散对纠正脓毒症免疫功能紊乱和改善患者症状的临床疗效。方法选取2014年6月至2016年6月在宁夏回族自治区工人医院就诊的53例脓毒症患者作为研究对象,根据住院号的奇偶性分为观察组(n=28)和对照组(n=25)。2组均予以西医常规治疗,观察组在此基础上加用升降散治疗,对照组则相应给予生理盐水。观察2组在治疗后第1、3和7天的免疫指标变化和记录28天内的临床结局。结果与对照组相比,观察组患者在给药第7天时的CD4~+T细胞计数、CD8~+T细胞计数和m HLADR表达显著增加(P<0.05)。进一步评估单核细胞功能结果显示,与对照组相比,观察组患者在给药第3天和第7天的单核细胞分泌的IL-6和TNF-α水平显著提高(P<0.05),而在第7天的IL-10水平显著降低(P<0.05)。观察组患者的ICU住院时间、APACHE II评分、Marshall评分和血管加压素使用时间均显著低于对照组(P<0.05)。结论升降散可以纠正脓毒症患者的细胞免疫,并且可作为一个有希望的脓毒症辅助治疗方案。
Objective To evaluate the clinical efficacy of Shengsheng San in correcting immune dysfunction and improving the symptoms of sepsis. Methods Fifty-three patients with sepsis from June 2014 to June 2016 in Ningxia Hui Autonomous Region Workers’ Hospital were enrolled in this study. According to the parity of inpatient numbers, they were divided into observation group (n = 28) and control group (n = 25). The two groups were treated with conventional Western medicine, the observation group on the basis of plus Shengjiang San treatment, while the control group was given saline. The changes of immune indexes on the 1st, 3rd and 7th day after treatment were observed in 2 groups and the clinical outcomes within 28 days were recorded. Results Compared with the control group, the CD4 ~ + T cell count, CD8 ~ + T cell count and m HLADR expression in the observation group increased significantly on the 7th day (P <0.05). Further evaluation of monocyte function results showed that the levels of IL-6 and TNF-α secreted by monocytes in the observation group were significantly increased (P <0.05) on day 3 and day 7 compared with the control group, While the level of IL-10 on day 7 was significantly lower (P <0.05). The ICU length of hospital stay, APACHE II score, Marshall score and vasopressin use time in the observation group were significantly lower than those in the control group (P <0.05). Conclusion Shengjing San can correct cellular immunity in sepsis patients, and can be used as a promising adjuvant treatment of sepsis.