| ObjectiveTo observe the effect of Shenfu injection on blood lactic acid level≥4.0mmol/L in patients with septic shock,and evaluate its clinical curative effect,in order to provide new ideas and methods for Shenfu injection in the treatment of septic shock.to observe the effect of Shenfu injection on the level of blood lactic acid in patients with septic shock,and to evaluate its clinical efficacy in order to provide new ideas and methods for Shenfu injection in the treatment of septic shock.MethodIn a prospective randomized controlled design,23 patients with septic shock who were hospitalized in the intensive care unit(ICU/EICU)of Guangdong Hospital of traditional Chinese Medicine from Dec 2018 to April 2020 and met the inclusion criteria were randomly divided into control group and experimental group at 1:1.The control group was treated with routine western medicine,and the experimental group was treated with Shenfu injection(100mlivdqd)on the basis of routine western medicine treatment.The course of treatment was 5 days.Lac,MAP,T lymphocyte subsets(CD4+,CD8+,+ CD4+/CD8+),coagulation indexes(APTT,PT,INR,FIB,D2 polymer,PLT),inflammatory indexes(CRP,PCT,WBC),blood gas analysis(PH,PaCO2,PaO2),7-day mortality,28-day mortality and hospitalization days were recorded before treatment,12 hours after treatment,3 days after treatment and 5 days after treatment.SOFA score,APACHEII score and Glasgow score system were used to score.In order to evaluate the improvement and clinical effect of Shenfu injection on blood lactic acid level in patients with septic shock,a comparison was made between groups.The data obtained from the experiment were statistically analyzed by using SPSS17.0 database.The counting data were described by frequency and rate,chi-square test or Fisher exact probability method were used for comparison between groups,M(P25-P75)was used to describe measurement data in accordance with normal distribution,independent sample t-test or one-way ANOVA was used to compare normal data,and non-parametric test was used to compare non-normal distribution data between groups.If the comparison data at multiple observation points are in accordance with normality,the repeated measurement analysis of variance is used,and the generalized estimation equation is used to compare them if they are not in accordance with normality.Taking a=0.05 as the test level,the difference was statistically significant(P<0.05).Result1.Comparison of general data before treatment:there was no significant difference in sex,age,height,weight,WBC,CRP,PCT,blood lactic acid,SOFA score and APACHEII score between the two groups(P>0.05).2.The SOFA score and Lac value of the two groups increased at 12 hours after entering the group,and decreased with the extension of treatment time(P<0.05),but there was no significant difference in the overall effect evaluation between the two groups(P>0.05).3.The APACHEII scores of the patients in the experimental group decreased with the prolongation of the treatment time,while the APACHEII scores of the patients in the control group increased at 12 hours after entering the group,and then showed a downward trend(P<0.05),but there was no significant difference in the overall effect evaluation between the two groups(P>0.05).4.The map value of the experimental group increased with the treatment time(P<0.05).The map value of the control group decreased at 12 hours after entering the group,and then increased(P<0.05),but there was no significant difference in the overall effect evaluation between the two groups(P>0.05).5.The WBC and CRP values of the two groups decreased with the prolongation of treatment time(P<0.05),but there was no significant difference in the overall effect evaluation between the two groups(P>0.05).6.Only the value of PCT in the experimental group decreased with the prolongation of treatment time(P<0.05).On the 5th day after entering the group,the value of PCT in the experimental group was lower than that in the control group(P<0.05),but there was no significant difference in the overall effect evaluation between the two groups(p>0.05).7.Comparison of safety indicators:there were no adverse reactions such as drug allergy between the two groups,and the death cases in the course of clinical treatment were analyzed to be caused by serious illness,which had nothing to do with drugs,and both groups were within the safe range.Concusion1.On the basis of conventional western medicine treatment,Shenfu injection intervention in patients with septic shock,its overall efficacy is similar to that of simple western medicine treatment,there is no allergic reaction in the treatment process and other adverse manifestations,it can be seen that the safety is reliable.2.Shenfu injection combined with routine western medicine treatment can reduce the level of blood lactic acid,increase the clearance rate of blood lactic acid,increase the mean arterial pressure,improve blood perfusion and microcirculation,and reduce the clinical mortality of patients with septic shock.3.Shenfu injection combined with routine western medicine treatment can reduce the CRP,PCT,WBC,SOFA score and APACHE-II score of patients with septic shock,and reduce the severity of septic shock patients.4.Shenfu injection is a representative prescription of the method of replenishing qi and warming yang,which provides a new direction for the treatment of patients with septic shock,which is worthy of in-depth study and wide application. |
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