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目的:观察清源生化汤对骨创伤后脓毒症患者心功能的影响。方法 :将60例骨创伤后脓毒症患者随机分为2组各30例,治疗组采用清源生化汤联合西医常规治疗,对照组仅采用西医常规治疗,观察治疗前后2组不同时间血浆肌酸激酶同工酶(CK-MB)、高敏心肌肌钙蛋白T(hs-c Tn T)、N末端脑利钠肽前体(NT-Pro BNP)、左心室射血分数(LVEF)、舒张早期/晚期心室充盈速度最大值比值(E/A比值)、左室舒张期末容积指数(LVEDVI)及左室收缩期末容积指数(LVESVI)的变化。结果:2组患者随着治疗时间的延长,CK-MB、hs-c Tn T及NT-Pro BNP逐渐下降,呈好转趋势。与同时段对照组比较,治疗组治疗后7天的hs-c Tn T、NT-Pro BNP及治疗后3天的NT-Pro BNP下降明显,差异均有统计学意义(P<0.05)。治疗7天后,2组患者E/A比值、LVEDVI及治疗组LVESVI较治疗前均有所好转(P<0.05);治疗7天后,治疗组的LVEF、LVEDVI改善较对照组更显著(P<0.05)。结论 :清源生化汤联合西医常规疗法治疗骨创伤后脓毒症,可减低患者心肌受损程度,改善心功能,对心脏有较好的保护作用。
Objective: To observe the influence of Qingyuan Shenghua Decoction on cardiac function in septic patients with bone trauma. Methods: Sixty patients with post-traumatic sepsis were randomly divided into two groups of 30 patients. The treatment group was treated with Qingyuan Shenghua Decoction combined with conventional western medicine. The control group was treated with conventional western medicine only. The changes of plasma muscle CK-MB, hs-c Tn T, NT-Pro BNP, LVEF, (E / A ratio), left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI). Results: The CK-MB, hs-c Tn T and NT-Pro BNP gradually decreased with the prolongation of treatment time in both groups. Compared with the control group, NT-Pro BNP and NT-Pro BNP decreased significantly on the 7th day after treatment in the treatment group, with statistical significance (P <0.05). After 7 days of treatment, the E / A ratio, LVEDVI and LVESVI in the two groups were all improved (P <0.05), and the improvement of LVEF and LVEDVI in the treatment group was more significant than that of the control group after 7 days of treatment ). Conclusion: Qingyuan Shenghua Decoction combined with Western conventional therapy in the treatment of post-traumatic sepsis can reduce the degree of myocardial damage, improve cardiac function and protect the heart better.