参附注射液对严重创伤患者免疫功能及病情预后的影响
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摘要
目的探讨参附注射液治疗严重创伤患者效果及对免疫功能、病情预后的影响。方法选取2016年1月~2017年6月因严重创伤于我院治疗的80例患者作为研究对象,依据随机数字表法将其分为两组,每组各40例。对照组患者采用常规治疗,观察组患者联合参附注射液进行治疗,7 d为1个疗程。比较两组患者的免疫功能指标(NK细胞、CD4~+/CD8~+、CD3~+)改善情况,比较两组患者的病死率及多器官功能障碍综合征(MODS)发生率。结果治疗后,观察组患者的NK细胞、CD4~+/CD8~+、CD3~+水平高于治疗前,差异有统计学意义(P<0.05)。治疗后,观察组患者的NK细胞、CD4~+/CD8~+、CD3~+水平高于对照组,差异有统计学意义(P<0.05)。观察组患者的MODS发生率是10.00%(4/40),病死率是5.00%(2/40),对照组患者的MODS发生率是35.00%(14/40),病死率是22.50%(9/40),观察组患者的MODS发生率及病死率均高于对照组,差异有统计学意义(P<0.05)。结论对严重创伤患者而言,早期应用参附注射液进行治疗具有重要意义,可有效改善患者的免疫功能,改善预后,值得推广。
Objective To investigate the effect of Shenfu Injection on the patients with severe trauma and the effect on the immune function and the prognosis of the patients.Methods A total of 80 patients with severe trauma treated in our hospital from January 2016 to June 2017 were selected as subjects and randomly divided into the control group and the control group according to the random digital table method,40 cases in each group.The control group was treated by conventional treatment,and the observation group was treated with Shenfu Injection for 7 days as one course of treatment.The two groups of immune functions indexes(NK cells,CD4~+/CD8~+,CD3~+) were compared,and the mortality of the two groups and the incidence of multiple organ dysfunction syndrome(MODS) were compared.Results After treatment,the observation group of NK cells,CD4~+/CD8~+and CD3~+were higher than those before treatment,the differences were statistically significant(P<0.05).The observation group of NK cells,CD4~+/CD8~+,CD3~+levels were higher than those of the control group after treatment,the differences were statistically significant(P<0.05).The incidence of MODS in the observation group was 10.00%(4/40) and the mortality rate was 5.00%(2/40),the incidences of MODS in the control group was35.00%(14/40) and the mortality rate was 22.50%(9/40),the incidence of MODS and mortality in the observation group were both higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The early application of Shenfu Injection for patients with severe trauma is of great significance.It can effectively improve the immune function and improve the prognosis.It is worth popularizing.
Objective To investigate the effect of Shenfu Injection on the patients with severe trauma and the effect on the immune function and the prognosis of the patients.Methods A total of 80 patients with severe trauma treated in our hospital from January 2016 to June 2017 were selected as subjects and randomly divided into the control group and the control group according to the random digital table method,40 cases in each group.The control group was treated by conventional treatment,and the observation group was treated with Shenfu Injection for 7 days as one course of treatment.The two groups of immune functions indexes(NK cells,CD4~+/CD8~+,CD3~+) were compared,and the mortality of the two groups and the incidence of multiple organ dysfunction syndrome(MODS) were compared.Results After treatment,the observation group of NK cells,CD4~+/CD8~+and CD3~+were higher than those before treatment,the differences were statistically significant(P<0.05).The observation group of NK cells,CD4~+/CD8~+,CD3~+levels were higher than those of the control group after treatment,the differences were statistically significant(P<0.05).The incidence of MODS in the observation group was 10.00%(4/40) and the mortality rate was 5.00%(2/40),the incidences of MODS in the control group was35.00%(14/40) and the mortality rate was 22.50%(9/40),the incidence of MODS and mortality in the observation group were both higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The early application of Shenfu Injection for patients with severe trauma is of great significance.It can effectively improve the immune function and improve the prognosis.It is worth popularizing.
引文
[1]雷李美,蓝翔,考验.参附注射液对严重创伤患者T细胞亚群、天然杀伤细胞及预后的影响[J].中华全科医学,2016,14(5):743-745.
[2]刘慧琳,刘桂花,田兆兴.脓毒症患者血中淋巴细胞水平的变化[J].中华危重病医学,2014,26(3):148-152.
[3]王阿凤,陆关珍.胸腹部创伤合并失血性休克的术前限制性液体复苏的疗效评价[J].中国实用护理杂志,2014,30(13):45-47.
[4]薛欣,王志永,刘建刚,等.重度烧伤并发脓毒症及治疗与血清IL-6,TNF-α,IL-10水平的相关性分析[J].现代中西医结合杂志,2015,24(6):636-637.
[5]赵旭明,秦陈浩,刘励军,等.严重创伤患者免疫功能抑制的影响因素[J].江苏医药,2014,40(7):785-788.
[6]龙涛,李智,白蓉蓉,等.外周血淋巴细胞亚群检测对脓毒血症患者的预后分析[J].中华医院感染学杂志,2015,25(14):3125-3127.
[7]高学民,李卓隽,苑振飞.加味黄连解毒汤灌肠联合电针干预治疗重症腹部外科术后患者胃肠功能障碍的效果[J].现代中西医结合杂志,2017,26(13):1408-1410.
[8]张伟军.参附注射液对感染性休克患者早期乳酸清除率的影响[J].甘肃医药,2015,1(6):56-57.
[9]王文龙.参附注射液治疗脓毒性休克作用机理分析[J].新中医,2015,47(3):3-5.
[10]耿延青.脓毒症患者血中CD4+、CD25+调节性T细胞水平与机体细胞免疫状态的相关性研究[J].中国医药导报,2015,3(2):7-10.
[11]王滨,边瑞民,魏传梅,等.头孢地嗪增加老年细菌性肺炎患者外周血CD4/CD8和Th1/Th2细胞比例[J].细胞与分子免疫学杂志,2015,4(13):528-531.
[12]刘学政,李桂伟.参附注射液治疗休克的临床研究[J].天津中医药大学学报,2012,31(1):12-13.
[13]邱泽亮,叶一萍,张宁,等.参附注射液对严重脓毒症免疫调节的前瞻性研究[J].中华中医药学刊,2012,30(2):363-366.
[14]宁易平,邱泽亮,牟莉,等.参附注射液对严重脓毒症病人T细胞亚群及天然杀伤细胞的影响[J].中华中医药学刊,2013,31(10):2270-2272.
[15]刘慧琳,刘桂花,田兆兴.脓毒症患者血中淋巴细胞水平的变化[J].中华危重病急救医学,2014,26(3):148-152.
[16]何林恒.创伤指数在急性创伤住院患者病情评估中的应用研究[J].中国当代医药,2016,23(3):31-33.
[17]徐岩,封江彬,陆雪,等.低剂量照射诱导人淋巴细胞53BP1焦点形成的剂量-效应关系研究[J].中国医学装备,2016,13(4):106-108.
[2]刘慧琳,刘桂花,田兆兴.脓毒症患者血中淋巴细胞水平的变化[J].中华危重病医学,2014,26(3):148-152.
[3]王阿凤,陆关珍.胸腹部创伤合并失血性休克的术前限制性液体复苏的疗效评价[J].中国实用护理杂志,2014,30(13):45-47.
[4]薛欣,王志永,刘建刚,等.重度烧伤并发脓毒症及治疗与血清IL-6,TNF-α,IL-10水平的相关性分析[J].现代中西医结合杂志,2015,24(6):636-637.
[5]赵旭明,秦陈浩,刘励军,等.严重创伤患者免疫功能抑制的影响因素[J].江苏医药,2014,40(7):785-788.
[6]龙涛,李智,白蓉蓉,等.外周血淋巴细胞亚群检测对脓毒血症患者的预后分析[J].中华医院感染学杂志,2015,25(14):3125-3127.
[7]高学民,李卓隽,苑振飞.加味黄连解毒汤灌肠联合电针干预治疗重症腹部外科术后患者胃肠功能障碍的效果[J].现代中西医结合杂志,2017,26(13):1408-1410.
[8]张伟军.参附注射液对感染性休克患者早期乳酸清除率的影响[J].甘肃医药,2015,1(6):56-57.
[9]王文龙.参附注射液治疗脓毒性休克作用机理分析[J].新中医,2015,47(3):3-5.
[10]耿延青.脓毒症患者血中CD4+、CD25+调节性T细胞水平与机体细胞免疫状态的相关性研究[J].中国医药导报,2015,3(2):7-10.
[11]王滨,边瑞民,魏传梅,等.头孢地嗪增加老年细菌性肺炎患者外周血CD4/CD8和Th1/Th2细胞比例[J].细胞与分子免疫学杂志,2015,4(13):528-531.
[12]刘学政,李桂伟.参附注射液治疗休克的临床研究[J].天津中医药大学学报,2012,31(1):12-13.
[13]邱泽亮,叶一萍,张宁,等.参附注射液对严重脓毒症免疫调节的前瞻性研究[J].中华中医药学刊,2012,30(2):363-366.
[14]宁易平,邱泽亮,牟莉,等.参附注射液对严重脓毒症病人T细胞亚群及天然杀伤细胞的影响[J].中华中医药学刊,2013,31(10):2270-2272.
[15]刘慧琳,刘桂花,田兆兴.脓毒症患者血中淋巴细胞水平的变化[J].中华危重病急救医学,2014,26(3):148-152.
[16]何林恒.创伤指数在急性创伤住院患者病情评估中的应用研究[J].中国当代医药,2016,23(3):31-33.
[17]徐岩,封江彬,陆雪,等.低剂量照射诱导人淋巴细胞53BP1焦点形成的剂量-效应关系研究[J].中国医学装备,2016,13(4):106-108.