参麦、前列地尔和还原性谷胱甘肽治疗全身炎症反应综合征

doi:10.3969/j.issn.1672-5069.2015.02.017

摘要/Abstract

摘要： 目的探讨参麦、前列地尔联合还原性谷胱甘肽治疗全身炎症反应综合征（SIRS）的效果。方法 62例SIRS患者被随机分为两组,给予28例对照组患者常规综合治疗,34例治疗组患者在对照组治疗的基础上加用参麦、前列地尔和还原性谷胱甘肽注射液静脉滴注,两组均连续应用7 d,比较两组患者血清白介素- 6（ IL- 6）、IL-10、肿瘤坏死因子-α （TNF-α）、C反应蛋白（CRP）水平,以及多器官功能障碍综合征（MODS）的发生率及病死率。结果在治疗7 d结束时,治疗组血清IL-6、TNF-α、CRP和 IL-10水平分别为（98.5±18.5） pg/ml、（31.8±9.5） ng/ml、（25.6±7.8） mg/ml和（92.5±24.5） μg/L,均显著低于对照组水平[分别为（180.6±34.5） pg/ml、（58.6±15.8） ng/ml、（40.5±10.2） mg/ml和（72.8±18.0） μg/L,P<0.01];对照组MODS发生率为35.6%,明显高于治疗组（11.8%,P<0.05）;治疗组和对照组病死率分别为5.9%和21.4%,组间差异无统计学意义（P>0.05）。结论参麦、前列地尔联合还原性谷胱甘肽注射液可能通过调控机体炎症反应,阻断SIRS向MODS发展,对SIRS患者具有较好的治疗作用。

关键词: 全身炎症反应综合征, 参麦注射液, 前列地尔, 还原性谷胱甘肽, 疗效

Abstract: Objective To investigate the efficacy of Shengmai,a herbal medicine,alprostadil and reduced glutathione in treatment of patients with systemic inflammatory response syndrome（SIRS）. Methods Sixty-two patients with SIRS were randomly divided into two groups. Patients in control group（n=28） received basic treatment,and patients in treatment group（n=34） were given Shengmai,alprostadil and reduced glutathione injections intravenously for 7 days at the basic treatment. The serum levels of serum interleukin 6（IL-6）,IL-10,tumor necrosis factor alpha （TNF-α） and C reactive protein （CRP）,and incidences of multiple organ dysfunction syndrome（MODS） as well as mortality rates in the two groups were recorded and compared. Results After 7 day treatment,the levels of serum IL-6,TNF-α,IL-10 and CRP in patients in treatment group were（98.5±18.5） pg/ml,（31.8±9.5） ng/ml,（25.6±7.8） mg/ml and （92.5±24.5） μg/L,significantly lower than those in the controls [（180.6±34.5） pg/ml,（58.6±15.8） ng/ml,（40.5±10.2） mg/ml and 72.8±18.0） μg/L,respectively,P<0.01];The incidence of MODS in control patients was 35.6%,significantly higher than that in treatment group （11.8%,P<0.05）; The mortality rates of patients in treatment and in control group were 5.9% and 21.4%,respectively,which had no significant statistical difference（P>0.05）. Conclusions Shenmai,alprostadil and reduced glutathione injection were effective in blocking SIRS process,which might be related to the inhibition of inflammatory response.

Key words: Systemic inflammatory response syndrome, Shengmai injection, Alprostadil, Reduced glutathione, Therapy

占国清, 谭华炳, 李芳, 李刚, 李儒贵, 郭鹏, 雷飞飞. 参麦、前列地尔和还原性谷胱甘肽治疗全身炎症反应综合征[J]. 实用肝脏病杂志, 2015, 18(2): 178-181.

Zhan Guoqing, Tan Huabing, Li Fang, et al.. Efficacy of Shengmai,alprostadil and reduced glutathione in treatment of patients with systemic inflammatory response syndrome[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2015, 18(2): 178-181.

参考文献

[1] Semeraro N,Ammollo CT,Semeraro F,et al. Sepsis,thrombosis and organ dysfunction. Thrombosis Res,2012,129（3）:290-295.
[2] 李金来,华艳梅,陆文,等. 连续性血液滤过联合乌司他丁治疗全身炎症反应综合征患者临床研究. 医学理论与实践,2011,24（9）:993-994,1008.
[3] 陈霞.全身炎症反应综合征的研究进展.临床医药实践,2010, 19（8B）:1087-1088.
[4] 梁伦昌,梁茂锦,谭其平,等. 低分子肝素、乌他司丁及谷胱甘肽应用于全身炎症反应综合征的疗效. 临床医学,2010,30（6）:11-12.
[5] Levels JH,Lemaire LC,van den Ende AE,et al. Lipid composition and lipopolysaccharide binding capacity of lipoproteins in plasma and lymph of patients with systemic inflammatory response syndrome and multiple organ failure. Crit Care Med,2003,31（6）:1647-1653.
[6] American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med,1992,20（6）:864-874.
[7] 王今达,王宝恩. 多脏器功能失常综合征（MODS）病情分期诊断及严重程度评分标准. 中国危重病急救医学,1995,7（6）:346-347.
[8] 陈匡,杨晓琨. 参麦注射液治疗全身炎症反应综合征41例疗效观察. 中国中医急症,2009,18（3）:384,389.
[9] 董广涛,王秀洁,唐政坤,等. 全身炎症反应综合征载脂蛋白AI的变化及临床意义. 中国急救医学2006,26（2）:108-110.
[10] Zhang Q,Raoof M,Chen Y,et al. Circulating mitochondrial DAMPs cause inflammatory responses to injury. Nature,2010,464（7285）:104-107.
[11] Semeraro N,Ammollo CT,Semeraro F,et al. Sepsis,thrombosis and organ dysfunction. Thrombosis Res,2012,129（3）:290-295.
[12] 鲁俊,陈明祺,耿艳霞,等. 益气通瘀法对多器官功能障碍综合征全身炎症反应和凝血功能影响. 中国中西医结合杂志,2014,34（1）:35-38.
[13] 蔡挺,陈童恩,杨群,等. 还原型谷胱甘肽治疗重度创伤后全身炎症反应综合征观察. 中国现代应用药学杂志,2006,23（3）:258-259.
[14] 黄中伟,唐建忠,袁鼎山,等. 还原型谷胱甘肽对急性胰腺炎全身炎症反应综合征的治疗作用. 中华急诊医学杂志,2005,14（2）:148-150.
[15] Borrelli E,Roux-Lombard P,Grau GE,et al. Plasma concentrations of cytokines,their soluble receptors,and antioxidant vitamins can predict the development of multiple organ failure in patients at risk. Crit Care Med,1996,24（3）:392-397.
[16] Jarrar D,Wolf SE,Jeschke MG,et al. Growth hormone attenuates the acute-phase response to thermal injury. Arch Surg,1997,132（11）:1171-1175.
[17] De M aio A,De Mooney ML,Matesic LE,et al. Genetic component in the inflammatory response induced by bacterial lipopoly saccharide. Shock,1998,10（5）:319-323.
[18] 赵明,蒋鹏,汪小海. 参麦、丹参注射液治疗全身炎症反应综合征. 江苏医药,2009,35（12）:1467-1469.
[19] Strate T,Mann O,Kleinhans H,et al. Systemic intravenous infusion of bovine hemoglobin significantly reduces microcirculatory dysfunction in experimentally induced pancreatitis in the rat. Ann Surg,2003,238（5）:765-771.
[20] 梁一梅,梁一举,杨朝晖. 前列腺素E1 在全身炎症反应综合征治疗中的应用. 现代医药卫生,2006,22（2）:162-163.