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目的探讨芪参活血颗粒对肺炎合并脓毒症患儿炎症反应以及脏器功能保护作用的影响。方法选取2014年7月-2016年6月收治的138例肺炎合并脓毒症患儿作为研究对象,采取随机数字表将138例患儿分成两组,每组69例。两组患儿均给予常规治疗,观察组在此基础上联合芪参活血颗粒治疗,比较两组临床疗效,同时于治疗前、治疗第3、7天检测两组患儿血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、CD_4~+、CD_(25)~+调节性T淋巴细胞(Treg细胞)比例以及肌酸激酶同工酶(CK-MB)、肌酐(Scr)、天冬氨酸氨基转移酶(AST)、脑钠肽(BNP)水平。结果观察组治疗总有效率为89.86%,对照组为71.01%,观察组总有效率明显高于对照组(P<0.01)。两组治疗3、7 d血清PCT、hs-CRP、Treg细胞比例均较治疗前有明显下降(P<0.01),观察组治疗3、7 d血清PCT、hs-CRP、Treg细胞比例明显低于同期对照组(P<0.01)。两组治疗3、7 d血清CK-MB、Scr、AST、BNP水平均较治疗前有明显下降(P<0.05),观察组治疗3、7 d血清CK-MB、Scr、AST、BNP水平明显低于同期对照组(P<0.05)。结论在常规治疗基础上联合芪参活血颗粒治疗小儿肺炎合并脓毒症可有效缓解患儿体内炎症反应,保护脏器功能,疗效确切。
Objective To investigate the effect of Qishen Huoxue Granule on inflammatory reaction and organ function in children with pneumonia complicated with sepsis. Methods A total of 138 children with pneumonia and sepsis admitted from July 2014 to June 2016 were selected as the study subjects and 138 children were divided into two groups (n = 69) with random number table. The two groups of children were given conventional treatment, the observation group on this basis combined with Qishenhuoxue particles treatment, the clinical efficacy of the two groups were compared, at the same time before treatment, 3,7 days after treatment, two groups of children with serum procalcitonin PCT, hs-CRP, CD_4 ~ +, CD25 + Treg cells, as well as creatine kinase (CK) and creatinine ), Aspartate aminotransferase (AST), brain natriuretic peptide (BNP) levels. Results The total effective rate was 89.86% in the observation group and 71.01% in the control group. The total effective rate in the observation group was significantly higher than that in the control group (P <0.01). The PCT, hs-CRP and Treg cell ratio of the two groups were significantly decreased on the 3rd and 7th day after treatment (P <0.01), and the proportion of PCT, hs-CRP and Treg cells in the observation group was significantly lower than that on the 3rd and 7th day Concurrent control group (P <0.01). Serum levels of CK-MB, Scr, AST and BNP in both groups were significantly decreased at 3 and 7 days after treatment (P <0.05). Serum levels of CK-MB, Scr, AST and BNP in observation group were significantly higher than those before treatment Lower than the control group (P <0.05). Conclusion The combination of Qishen Huoxue Granule with conventional treatment on pneumonia and sepsis in children can effectively relieve the inflammatory reaction and protect the function of organ in children, and the curative effect is definite.