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目的探讨通腑净化汤对创伤后脓毒症休克患者血流动力学、组织氧代谢的变化及临床意义。方法 60例患者随机分入治疗组和对照组,每组30例。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。观察治疗前以及治疗后6、12、24、48 h患者血流动力学与组织氧代谢各指标变化情况。结果与本组治疗前比较,两组各时间点血流动力学指标变化均有明显改善,而两组各时间点各项组织氧代谢指标除对照组治疗后12 h氧摄取率(O2ER)均有明显改善,差异有统计学意义(P<0.05,P<0.01)。与对照组治疗后比较,治疗组心率(HR)、体循环阻力(SVR)、心输出量(CO)改善明显,差异有统计学意义(P<0.05,P<0.01),平均动脉压(MAP)、中心静脉压(CVP)、心排指数(CI)在治疗后6、12、24 h改善明显,差异有统计学意义(P<0.05,P<0.01)。治疗组在治疗后各时间点组织氧代谢各项指标均较对照组有改善,差异有统计学意义(P<0.05,P<0.01)。结论通腑净化汤联合西医常规治疗脓毒症休克,可较迅速改善患者血流动力学异常和组织氧代谢障碍,疗效优于单纯西医治疗。
Objective To investigate the changes of hemodynamics and tissue oxygen metabolism in patients with post-traumatic sepsis shock and the clinical significance. Methods 60 patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group Tongfu Purification Decoction and Western conventional treatment, the control group only conventional treatment of Western medicine. The changes of hemodynamics and tissue oxygen metabolism before and 6, 12, 24 and 48 h after treatment were observed. Results Compared with before treatment, the changes of hemodynamics indexes of two groups were significantly improved at each time point. The oxygen metabolism index of each group at each time point was lower than that of control group at 12 h after treatment (O2ER) There was a significant improvement, the difference was statistically significant (P <0.05, P <0.01). Compared with the control group, HR, SVR and CO in treatment group were significantly improved (P <0.05, P <0.01), mean arterial pressure (MAP) , Central venous pressure (CVP) and cardiac index (CI) improved significantly at 6, 12 and 24 h after treatment. The difference was statistically significant (P <0.05, P <0.01). The indexes of oxygen metabolism in the treatment group improved at all time points after treatment compared with the control group, the difference was statistically significant (P <0.05, P <0.01). Conclusion Tongfu Purification Decoction combined with Western conventional treatment of septic shock, can be more rapidly improve hemodynamic abnormalities and tissue oxygen metabolism disorders, the effect is superior to Western medicine alone.