血必净注射液改善热毒血瘀型脓毒症急性肺损伤患者呼吸功能及预后的临床研究

Clinical Study on the Effect of Xuebijing Injection on Respiratory Function and Prognosis in Sepsis-Induced Acute Lung Injury Patients with Syndrome of Heat-Toxin and Blood Stasis

    摘要
  • 摘要:
    目的 观察血必净注射液对热毒血瘀型脓毒症急性肺损伤（ALI）患者呼吸功能、预后的影响及疗效机制。
    方法 采用随机数字表法将60例脓毒症ALI患者分为对照组、血必净组各30例。对照组予临床公认的常规方案治疗，血必净组在对照组治疗基础上加用血必净注射液静脉滴注，2组均连续治疗7 d。治疗前、治疗7 d比较2组患者病情相关评分急性生理学与慢性健康状况（APACHE Ⅱ）、序贯器官衰竭评估（SOFA）、肺损伤（LIS）评分、呼吸功能指标（氧合指数、气管插管比例、使用机械通气比例和机械通气时间）、炎症指标白细胞计数、C反应蛋白（CRP）和降钙素原（PCT）水平变化，评估2组患者预后指标（ICU住院时间和28 d病死率）。
    结果 治疗7 d，2组氧合指数均显著升高（P<0.05，P<0.01），血必净组高于对照组（P<0.01）；2组APACHE Ⅱ、LIS评分、中医证候积分及CRP、PCT水平均显著降低（P<0.05，P<0.01），血必净组SOFA评分显著降低（P<0.01），血必净组APACHE Ⅱ评分、SOFA评分、发热证候积分及CRP水平均低于对照组（P<0.05）。长期随访显示，血必净组患者机械通气时长、ICU住院时间均低于对照组（P<0.05）。
    结论 血必净注射液可有效改善脓毒症ALI患者的呼吸功能，纠正组织缺氧，抑制炎症反应，缩短ICU住院时间并降低呼吸机使用率及危重症相关评分，但对患者28 d病死率无明显影响。

     

    Abstract:
    OBJECTIVE To assess the clinical efficacy and prognostic impact of Xuebijing injection in the treatment of sepsis-induced acute lung injury (ALI) patients with the syndrome of heat-toxin and blood stasis and its therapeutic mechanism.
    METHODS Sixty patients with ALI of sepsis were randomly divided into a control group and a Xuebijing group, with 30 patients in each group. The control group received the clinically recognized routine treatment, while the Xuebijing group received Xuebijing injection intravenously in addition to the treatment of the control group. Both groups were treated continuously for 7 days. Before treatment and after 7 days of treatment, changes in disease-related scores (APACHE Ⅱ, SOFA, and LIS scores), respiratory function indicators (oxygenation index, endotracheal intubation rate, mechanical ventilation rate, and mechanical ventilation time), and inflammatory markers (white blood cell count, C-reactive protein (CRP), and procalcitonin) were compared between the two groups. Prognostic indicators (ICU length of stay and 28-day mortality) were also assessed in the two groups.
    RESULTS After 7 days of treatment, the oxygenation index of both groups significantly increased (P<0.05, P<0.01), with the Xuebijing group showing a higher index than the control group (P<0.01). The APACHE Ⅱ score, LIS score, TCM syndrome score, and CRP and PCT levels of both groups significantly decreased (P<0.05, P<0.01), while the SOFA score of the Xuebijing group was significantly lower (P<0.01). The APACHE Ⅱ score, SOFA score, fever syndrome score, and CRP level of the Xuebijing group were all lower than those of the control group (P<0.05). Long-term follow-up showed that the duration of mechanical ventilation and ICU stay in the Xuebijing group were shorter than those in the control group (P<0.05).
    CONCLUSION Xuebijing injection can effectively improve respiratory function, correct tissue hypoxia, inhibit inflammatory response, shorten ICU stay, and reduce ventilator usage and critical illness-related scores in patients with sepsis-induced ALI. However, it has no significant effect on the 28-day mortality rate.

     

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