加味防己茯苓汤联合CRRT疗法对脓毒症急性肾损伤患者肾功能及血清APN、PCT、Lac水平变化的影响

摘要/Abstract

摘要： 目的：探讨加味防己茯苓汤联合持续肾脏替代治疗（CRRT）对脓毒症急性肾损伤患者肾功能及血清脂联素（APN）、降钙素原（PCT）、乳酸（Lac）水平变化的影响。方法：选取2014年6月至2017年2月我院78例脓毒症急性肾损伤患者，随机数字表法分为对照组（n=39）与研究组（n=39）。对照组采取CRRT治疗，研究组采取CRRT疗法+加味防己茯苓汤，持续服用28 d。入院时及治疗结束后统计对比两组中医证候积分、肾功能指标[尿酸（UA）、尿素氮（BUN）、肌酐（Scr）]、血清PCT、APN、Lac水平、7 d及28 d病死率。结果：治疗后两组中医证候积分较治疗前降低，且研究组较对照组低（P＜0.05）；治疗后两组UA、BUN、Scr水平较治疗前均降低，且研究组肾功能指标水平较对照组均低（P＜0.05）；治疗后两组血清PCT、Lac水平较治疗前降低，血清APN水平较治疗前增高，且研究组血清PCT、Lac水平较对照组低，血清APN水平较对照组高（P＜0.05）；研究组7 d及28 d病死率（5.13%、7.69%）较对照组（12.82%、28.21%）低，且两组28 d病死率比较，差异有统计学意义（P＜0.05）。结论：联合采用CRRT疗法及加味防己茯苓汤治疗脓毒症急性肾损伤患者效果显著，可有效缓解其临床症状，改善血清APN、PCT、Lac水平，促使肾功能恢复，降低病死率。

Abstract: Objective：To investigate the effects of modified fangji fuling decoction combined with CRRT therapy on renal function， serum APN， PCT and Lac levels in patients with sepsis-induced acute kidney injury. Methods： 78 patients with sepsis-induced acute renal injury in our hospital from June 2014 to February 2017 were randomly divided into the control group (n=39) and the study group (n=39). The control group was treated with CRRT therapy， while the study group was treated with CRRT therapy combined with taking modified fangji fuling decoction for 28 d. The statistical indicators end before and after treatment were compared between the two groups， including TCM syndrome score， renal function index， such as uric acid (UA)， urea nitrogen (BUN)， creatinine (Scr)， serum PCT， APN， Lac level， and the mortality rate of 7 d and 28 d. Results： After treatment， the scores of TCM syndromes in the two groups were lower than those before treatment， and the study group was lower than that of the control group（P＜0.05）. After treatment， the levels of UA， BUN and Scr in the two groups were lower than those before the treatment， and the level of renal function index in the study group was lower than that in the control group（P＜0.05）. After treatment， serum PCT and Lac levels in the two groups were lower than those before treatment， serum APN levels were higher than those before treatment， and serum PCT and Lac levels in the study group were lower than those in the control group， and the serum APN level was higher than that in the control group（P＜0.05）. The mortality rates in the study group of 7 d and 28 d（5.13%、7.69%） were lower than those in the control group (12.82% and 28.21%)， and there was significant difference in the mortality rate of the 28 d between the two groups（P＜0.05）. Conclusion： Modified fangji fuling decoction combined with CRRT therapy on patients with sepsis-induiced acute kidney injury can effectively alleviate the clinical symptoms， improve the serum levels of APN， PCT， Lac， promote the recovery of renal function， decrease the mortality rate.

杜晓敏. 加味防己茯苓汤联合CRRT疗法对脓毒症急性肾损伤患者肾功能及血清APN、PCT、Lac水平变化的影响[J]. .

Du Xiaomin. Effects of Modified Fangji Fuling Decoction Combined with CRRT Therapy on Renal Function， Serum APN， PCT and Lac Levels in Patients with Sepsis-induced Acute Kidney Injury[J]. .

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