基于三焦分消理论拟定三八抗毒汤治疗尿源性脓毒症的临床疗效研究OA
Clinical efficacy study of Sanba Kangdu decoction in the treatment of urosepsis based on the Sanjiao Fenxiao theory
目的 探讨基于三焦分消理论拟定三八抗毒汤治疗尿源性脓毒症的疗效.方法 选择 2022 年7 月至 2025 年 12 月柳州市中医医院泌尿外科收治的 72 例尿源性脓毒症患者作为研究对象,按随机数字表法将患者分为观察组和对照组,每组 36 例.对照组采用西医常规治疗,观察组在对照组基础上加用中药汤剂三八抗毒汤(方剂组成:木通10 g、车前子15 g、萹蓄15 g、瞿麦15 g、大黄5 g、栀子15 g、滑石30 g、灯心草20 g、甘草 10 g、杏仁 15 g、豆蔻 15 g、薏苡仁 30 g、半夏 15 g、厚朴 20 g).比较两组主要终点,包括中医证候积分、血清炎症因子[降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)]、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA),以及次要终点,包括血小板计数(PLT)、血肌酐(SCr)、总胆红素(TBil)等指标的差异.结果 治疗前两组各指标比较差异均无统计学意义.治疗 7 d后,各指标均较治疗前明显改善,与对照组比较,观察组的中医证候积分、APACHEⅡ评分、SOFA评分、CRP、PCT、IL-6、SCr、TBil均明显降低[发热(分):0.62±0.18 比 1.04±0.14,寒战(分):1.07±0.03 比 1.12±0.13,腰腹疼痛(分):0.61±0.13 比0.74±0.10,尿液性状(分):0.89±0.07 比 0.94±0.09,APACHEⅡ评分(分):16.14±2.24 比 21.56±4.72,SOFA评 分(分):7.21±1.66 比 10.97±2.71,CRP(mg/L):13.65±7.96 比 22.32±9.64,PCT(μg/L):2.25±0.76 比3.48±1.12,IL-6(ng/L):129.75±21.15 比 246.32±36.90,SCr(μmol/L):98.54±19.36 比 122.42±21.57,TBil(μmol/L):17.34±3.02 比 22.25±3.78,均P＜0.05],PLT明显升高(×109/L:247.36±42.76 比 208.42±28.75,P＜0.05).随访 3 个月,两组病死率、治愈率比较差异均无统计学意义.结论 三八抗毒汤可显著改善尿源性脓毒症患者临床症状及全身炎症反应,改善凝血功能及器官功能障碍,具有积极临床意义.
Objective To evaluate the efficacy of Sanba Kangdu decoction,based on the Sanjiao Fenxiao theory,in the treatment of urosepsis.Methods A total of 72 patients with urosepsis admitted to the department of urinary surgery of Liuzhou Hospital of Traditional Chinese Medicine from July 2022 to December 2025 were enrolled.Using a random number table,the patients were assigned to an observation group and a control group(36 cases each).The control group received conventional Western medical treatment,while the observation group additionally received Sanba Kangdu decoction.The formula consisted of Prunella 10 g,Plantago Seed 15 g,Plantago Asiatica 15 g,Phellodendron 15 g,Rhubarb 5 g,Gardenia 15 g,Gypsum 30 g,Lotus Root Fiber 20 g,Licorice 10 g,Almond 15 g,Cardamom 15 g,Coix Seed 30 g,Pinellia Rhizome 15 g,Magnolia Bark 20 g.The primary endpoints included traditional Chinese medicine(TCM)syndrome scores,serum inflammatory markers[including procalcitonin(PCT),C-reactive protein(CRP),and interleukin-6(IL-6)],acute physiology and chronic health evaluationⅡ(APACHEⅡ),and sequential organ failure assessment(SOFA)score.The secondary endpoints included platelet count(PLT),serum creatinine(SCr),and total bilirubin(TBil).Results No statistically significant differences were observed between the two groups regarding any of the baseline parameters.After 7 days of treatment,all indicators were improved significantly in both groups compared with the baseline.Compared with the control group,the observation group showed significantly lower TCM symptom scores,APACHEⅡscore,SOFA score,PCT,CRP,and IL-6 levels,as well as lower SCr and TBil levels[fever:0.62±0.18 vs.1.04±0.14,chills:1.07±0.03 vs.1.12±0.13,lumbar and abdominal pain:0.61±0.13 vs.0.74±0.10,urine characteristics:0.89±0.07 vs.0.94±0.09,APACHEⅡscore:16.14±2.24 vs.21.56±4.72,SOFA score:7.21±1.66 vs.10.97±2.71,CRP(mg/L):13.65±7.96 vs.22.32±9.64,PCT(μg/L):2.25±0.76 vs.3.48±1.12,IL-6(ng/L):29.75±21.15 vs.246.32±36.90,SCr(μmol/L):98.54±19.36 vs.122.42±21.57,TBil(μmol/L):17.34±3.02 vs.22.25±3.78;all P<0.05],PLT was significantly higher in the observation group than that in the control group(×109/L:247.36±42.76 vs.208.42±28.75,P<0.05).At the 3-month follow-up,there were no statistically significant differences between the two groups in mortality or cure rate.Conclusion Sanba Kangdu decoction can significantly improve clinical symptoms and systemic inflammatory response in patients with urosepsis,enhance coagulation function and alleviate organ dysfunction,demonstrating positive clinical significance.
张永利;李慧霞;刘权;张小平
柳州市中医医院泌尿外科,广西壮族自治区 柳州 545001湖北中医药大学,湖北 武汉 430065柳州市中医医院泌尿外科,广西壮族自治区 柳州 545001柳州市中医医院泌尿外科,广西壮族自治区 柳州 545001
尿源性脓毒症炎症因子中医经典方剂休克
UrosepsisInflammatory factorClassic Chinese medicine prescriptionShock
《中国中西医结合急救杂志》 2026 (3)
288-292,5
广西壮族自治区中医药管理局科研课题(GXZYB20220396)Scientific Research Project of the Traditional Chinese Medicine Administration of Guangxi Zhuang Autonomous Region(GXZYB20220396)
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