CAJ | 학술논문

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。
목적：탐토삼맥、전렬지이연합환원성곡광감태치료전신염증반응종합정（SIRS）적효과。방법62례SIRS환자피수궤분위량조，급여28례대조조환자상규종합치료，34례치료조환자재대조조치료적기출상가용삼맥、전렬지이화환원성곡광감태주사액정맥적주，량조균련속응용7 d，비교량조환자혈청백개소-6（ IL-6）、IL-10、종류배사인자-α（TNF-α）、C반응단백（CRP）수평，이급다기관공능장애종합정（MODS）적발생솔급병사솔。결과재치료7 d결속시，치료조혈청IL-6、TNF-α、CRP화 IL-10수평분별위（98.5±18.5） pg/ml、（31.8±9.5） ng/ml、（25.6±7.8） mg/ml화（92.5±24.5）μg/L，균현저저우대조조수평[분별위（180.6±34.5） pg/ml、（58.6±15.8） ng/ml、（40.5±10.2） mg/ml화（72.8±18.0）μg/L，P＜0.01]；대조조MODS발생솔위35.6%，명현고우치료조（11.8%，P＜0.05）；치료조화대조조병사솔분별위5.9%화21.4%，조간차이무통계학의의（P>0.05）。결론삼맥、전렬지이연합환원성곡광감태주사액가능통과조공궤체염증반응，조단SIRS향MODS발전，대SIRS환자구유교호적치료작용。
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 treat-ment,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 syn-drome (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 inci-dence 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.