清热通腑法治疗脓毒症的临床观察

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1、提要目的：评价清热通腑法辅助治疗脓毒症毒热内盛证临床疗效并初步探讨其作用机理，以进行探索关于中西医结合治疗的脓毒症新途径。方法：选择2011年4月－2012年4月收治于山东省中医院急诊科、ICU病房的60例脓毒症毒热内盛证或瘀毒内阻证患者，随机分为治疗组（30例，采用西医常规治疗+五味消毒饮合小承气汤加减组方中药），对照组（30例，采用西医常规治疗），以进行前瞻性对照研究。分别于入选时及疗程结束时进行一般生命体征检查、APACHEⅡ评分、抽取静脉血测定观察指标，用以观察治疗前后各项指标的变化情况。采用SPSS17.0软件进

2、行统计分析。结果：经治疗7天后，治疗组与对照组比较存在限制性差异（P＜0.05）。同时，APACHEⅡ积分、体温（T）、心率（P）、呼吸频率（R）、白细胞总数（WBC）、中性粒细胞总数（NEU）、中性粒细胞百分比（NEU%）、C反应蛋白（CRP）明显降低（P＜0.05或P＜0.01）结论：清热通腑法以五味消毒饮合小承气汤加减组方对脓毒症有较好的干预治疗作用。关键词：脓毒症；清热通腑法；五味消毒饮；小承气汤；临床疗效ClinicalresearchoftherapyofQingretongfutotreatSepsisSpe

3、ciality：InternalMedicineofTraditionalChineseMedicineAuthor：YanSuTutor：Prof.YoukeAbstractObjective：ThisresearchapplythetherapyofQingretongfutotreatpatientswithSepsis，whichmayprovideanewwayforthetreatmentofSepsiswiththecombinationofChinesemedicineandwesternmedicine.

4、Methods:OurstudywasperformedattheAffiliatedHospitalofShandongUniversityofTCM.Weconductedaprospectivecase-controlstudyon60SepsispatientsinICUfromApril2011toApril2012.The60patientswererandomlydividedintothetreatmentgroupandthecontrastgroup.Thecontrastgroupwasreceive

5、dcommonwesternmedicinetherapyandtheotherreceivedQingretongfutherapyexceptforthecommonwesternmedicinetherapy.OnthefirstdaybeforestartsoftreatmentandDay7afterthetreatment,werecordedtheAPACHEⅡscore,andtheinvestigatedparameters.AlldatawereanalyzedwithSPSS17.0.Results:

6、Oneweeklater,wefoundtreatmentgroupcomparedwithcontrastgroup,whichwassignificantdifference(P＜0.05).Atthesametime,wefoundthistherapycansignificantlydecreasedthelevelofAPACHEscore,T,P,R,WBC,Neu,Neu%,CRP.Comparedwithcontrastgroup,thereweresignificantdifference(P＜0.05)

7、.Conclusions:QingretongfutherapycombinedwithnormalwesternmedicinecaneffectivelytreatthepatientswithSepsis.KeywordsSepsis;Qingretongfutherapy;WuweixiaoduTang;XiaochengqiTang;Clinicaleffect目录引言.........................................................................

8、......................................................1临床研究.............................................................................................