中国中西医结合外科杂志2017，Vol.23Issue(4)：349-352,365,5.DOI:10.3969/j.issn.1007-6948.2017.04.003
参麦注射液联合尿蛋白酶抑制剂对创伤脓毒症患者免疫调理的临床观察
The Immunomodulation by Shenmai Injection and Ulinastatin in Patients with Posttraumatic Sepsis
摘要
Abstract
Objective To explore whether Shenmai injection combined with Ulinastatin has effects on im?munomodulation in patients with posttraumatic sepsis. Methods Sixty patients with posttraumatic sepsis were randomly divided into treatment group and control group (30 cases in each group). The control group underwent the conventional treatment for sepsis (surviving sepsis campaign, SSC).The patients in the treatment group were administered Ulinastatin and Shenmai injection in addition to SSC. The peripheral venous blood samples of all the patients were drawn both before and third and 7th days after treatment. T lymphocyte subgroups were deter?mined in the blood samples by flow cytometry. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1) and IL-6 were determined by ELISA . APACHE II scoring system was used to observe the ICU treatment time, incidence of MODS and mortality rate in the two groups. Results There were significant differences be?tween the two groups in the ICU treatment time, incidence of MODS, and mortality rate. Before treatment, both CD4+ T cells and the ratio of CD4+/CD8+ were significantly decreased in the two groups. At the same time, the levels of IL-6 and TNF-α were increased but there were no significant differences between the two groups (P>0.05). After treatment, the above indexes in the treatment group were better than those in the control group. On the 7th day, the CD4+T cells and the ratio of CD4+/CD8+ in treatment group were(45.15±8.08)and(1.87±0.62), respectively. While the CD4+T cells and the ratio of CD4+/CD8+ in control group were (35.96 ± 7.13)and (1.51 ± 0.38), respectively. Both the CD4+T cells and the ratio of CD4+/CD8+ in treatment group were in?creased as compared to those in the control group.On the same 7th day, The levels of IL-6 and TNF-αand the APACHE II score in treatment group were(32.95± 9.1) pg/mL、(43.15 ± 15.4) pg/mL and(10.02 ± 5.21), respectively. While the IL-6 and TNF-α levels and the APACHE II score in the control group were(60.2± 8.05)pg/mL、(82.25±19.85)pg/mL and(16.04±6.45), re?spectively. The IL-6 and TNF-α levels and the APACHE II score were obviously improved in the treatment group compared with those in the control group. Conclusion Shenmai injection combined with Ulinastatin is of value in the treatment of traumatic sepsis. This strategy can inhibit the release of inflammatory factors, relieve the inflammatory reaction, and improve immune function.关键词
脓毒症/T淋巴细胞亚群/炎症介质/免疫调理/参麦注射液Key words
Sepsis/T lymphocyte subgroup/inflammatory mediators/immunomodulation/shenmai injec⁃tion分类
医药卫生引用本文复制引用
陈如康,吴伟,黄增峰,梁艳..参麦注射液联合尿蛋白酶抑制剂对创伤脓毒症患者免疫调理的临床观察[J].中国中西医结合外科杂志,2017,23(4):349-352,365,5.基金项目
浙江省中医药管理局基金资助项目(2004C157) （2004C157）
浙江省苍南县科技局基金资助项目(2014S32) （2014S32）
