CAJ | 학술논문

目的观察中西医结合治疗创伤后全身炎症反应综合征的疗效。方法将本院重症监护病房(ICU)收治的86例严重创伤后出现全身炎症反应综合征患者随机分为对照组和治疗组。对照组应用乌司他丁常规治疗。治疗组在此基础上加用血必净注射液50 mL静点，每日2次；大黄粉10 g胃管内注入，每日2次。疗程5 d。观察治疗前后2组的炎症因子水平及临床疗效。结果治疗组在治疗5 d 内肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8水平持续下降(P＜0.05)，而对照组TNF-α、IL-6、IL-8水平持续升高(P＜0.05)。治疗第1日2组CRP水平无明显差异(P＞0.05)，第2日起治疗组CRP均低于对照组(P＜0.05)。治疗组平均住院时间、ICU住院时间、28 d死亡率、急性生理及慢性健康状况评估Ⅱ评分均优于对照组(P＜0.05)。结论在西医常规治疗基础上加用血必净注射液及大黄粉可减轻机体炎症反应，有效抑制炎症介质的生成和释放，提高全身炎症反应综合征患者的生存率。
목적관찰중서의결합치료창상후전신염증반응종합정적료효。방법장본원중증감호병방(ICU)수치적86례엄중창상후출현전신염증반응종합정환자수궤분위대조조화치료조。대조조응용오사타정상규치료。치료조재차기출상가용혈필정주사액50 mL정점，매일2차；대황분10 g위관내주입，매일2차。료정5 d。관찰치료전후2조적염증인자수평급림상료효。결과치료조재치료5 d 내종류배사인자-α(TNF-α)、백세포개소(IL)-6、IL-8수평지속하강(P＜0.05)，이대조조TNF-α、IL-6、IL-8수평지속승고(P＜0.05)。치료제1일2조CRP수평무명현차이(P＞0.05)，제2일기치료조CRP균저우대조조(P＜0.05)。치료조평균주원시간、ICU주원시간、28 d사망솔、급성생리급만성건강상황평고Ⅱ평분균우우대조조(P＜0.05)。결론재서의상규치료기출상가용혈필정주사액급대황분가감경궤체염증반응，유효억제염증개질적생성화석방，제고전신염증반응종합정환자적생존솔。
Objective To observe the therapeutic effect of integrated traditional Chinese and western medicine treatment on systemic inflammatory response syndrome after trauma. Methods Totally 86 cases of severe trauma patients with systemic inflammatory response syndrome in ICU were randomly divided into control group and treatment group. The control group was given routine treatment of ulinastatin, and the treatment group was treated with Xuebijing injection 50 mL, intravenously injected twice per day and rhubarb powder 10 g through stomach tube twice per day for 5 days. The clinical effect and levels of inflammatory factors before and after treatment of the two groups were observed. Results During 5 days of treatment, the levels of TNF-α, IL-6 and IL-8 of the treatment group decreased continuously (P<0.05), while which of the control group increased continuously (P<0.05). CRP level of the two groups had no significant difference in the first day of treatment (P>0.05), but which of the treatment group was lower than the control group from the second day of treatment (P<0.05). The average hospital stay, ICU stay, 28 d mortality and APACHEⅡ score of the treatment group were better than that of the control group (P<0.05). Conclusion Xuebijing injection and rhubarb powder in addition to conventional treatment can relieve inflammatory response, effectively inhibit the generation and release of inflammatory mediators, improve the survival rate of systemic inflammatory response syndrome.