目的 观察宣白承气汤对肺炎所致脓毒症的临床疗效，并探究其作用机制。方法 将84例肺炎致脓毒症患者随机分为对照组和治疗组，每组42例，两组患者均给予西医常规治疗，治疗组在常规治疗的基础上加用宣白承气汤，比较两组患者治疗前后血乳酸（lactate acid，Lac）浓度、上腔静脉血氧饱和度（superior vena cava oxygen saturation，ScvO2）、降钙素原（procalcitonin，PCT）水平及社区获得性肺炎评分量表（confusion， urea， respiratory rate， blood pressure， age≥65，CURB-65）、序贯器官衰竭评估量表（sequential organ failure assessment，SOFA）评分。结果 与治疗前比较，两组患者治疗后Lac、PCT均显著降低（P＜0.05），ScvO2水平均显著升高（P＜0.05）；治疗组患者Lac降低程度和ScvO2升高程度显著大于对照组（P＜0.05）。与治疗前比较，两组患者治疗后CURB-65评分、SOFA评分均显著降低（P＜0.05），且治疗组患者CURB-65、SOFA评分降低程度显著大于对照组（P＜0.05）。结论 宣白承气汤能改善肺炎所致脓毒症患者的灌注指标，减轻炎症反应，效果显著。
Objective To investigate the clinical effect and mechanism of action of Xuanbai Chengqi Decoction in the treatment of patients with pneumonia-induced sepsis. Methods A total of 84 patients with pneumonia-induced sepsis were randomly divided into control group and treatment group, with 42 patients in each group. The patients in the control group were given conventional Western medicine treatment alone, and those in the treatment group were given Xuanbai Chengqi Decoction in addition to the conventional Western medicine treatment. The two groups were compared in terms of lactic acid (Lac) concentration, superior vena cava oxygen saturation (ScvO2), procalcitonin (PCT) level, CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥65) community-acquired pneumonia score, and sequential organ failure assessment (SOFA) score before and after treatment. Results After treatment, both groups had significant reductions in Lac and PCT (P<0.05) and a significant increase in ScvO2 (P<0.05), and compared with the control group, the treatment group had a significantly greater reduction in Lac and a significantly greater increase in ScvO2 (P<0.05). Both groups had significant reductions in CURB-65 and SOFA scores after treatment (P<0.05), and the treatment group had significantly greater reductions than the control group (P<0.05). Conclusion Xuanbai Chengqi Decoction has a good clinical effect in the treatment of patients with pneumonia-induced sepsis and can improve their perfusion index and reduce inflammatory response.
冯 博,邓 洋,温泽迎.宣白承气汤治疗肺炎致脓毒症42例临床观察[J].安徽中医药大学学报,2020,39(2):39-41复制