黄连解毒汤加味对脓毒症热毒炽盛证患者血流动力学和微循环灌注的影响

目的 探讨黄连解毒汤加味对脓毒症热毒炽盛证患者血流动力学及微循环灌注的影响。方法 选取符合诊断标准的患者60例，按随机数字表法将患者分为观察组30例及对照组30例，对照组患者采用传统抗感染、对症支持、稳定内环境等西医常规治疗，观察组患者在对照组的基础上加用黄连解毒汤加味治疗。观察两组患者治疗前及治疗后24 h、48 h血流动力学及微循环灌注指标的变化。结果 治疗24 h、48 h后，两组患者心率（heart rate， HR）、平均动脉压（mean arterial pressure， MAP）、中心静脉压（central venous pressure， CVP）、体循环阻力（systemic vascular resistance， SVR）、血管活性药用量（norepinephrine， NE）、血乳酸（blood lactic acid， LAC）、混合静脉血血氧饱和度（oxygen saturation of mixed venose blood， SCVO₂）、动静脉二氧化碳分压差（significance of venoarterial carbon dioxide difference， Pcv-aCO₂）均较治疗前明显改善（P<0.05），且观察组各项指标较对照组改善明显（P<0.05）。结论 对脓毒症热毒炽盛证患者联合应用西医常规配合黄连解毒汤加味治疗，可以有效改善患者血流动力学指标及组织低灌注水平，为临床治疗提供参考。

Effects of Modified Huanglian Jiedu Decoction on Hemodynamics and Microcirculation Perfusion in Patients with Sepsis of Blazing Heat-toxin Syndrome

Objective To explore effects of Modified Huanglian Jiedu Decoction on hemodynamics and microcirculation perfusion in patients with sepsis of blazing heat-toxin syndrome. Methods A total of 60 patients meeting diagnostic criteria were selected and divided into observation group (n=30) and control group (n=30) According to random number table method. The control group was treated with conventional western medicine such as traditional anti-infection, symptomatic support and stablizing internal environment, while the observation group was treated with Modified Huanglian Jiedu Decoction on the treatment basis of the control group. Index changes of hemodynamics and microcirculation perfusion in the 2 groups were observed before the treatment, as well as 24 h and 48 h after the treatment. Results After 24 h and 48 h after the treatment, heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), systemic vascular resistance (SVR), norepinephrine (NE), blood lactic acid (LAC), oxygen saturation of mixed venous blood (SCVO₂) and significance of venoarterial carbon dioxide difference (Pcv-aCO₂) in the 2 groups were significantly improved, compared with those before the treatment (P<0.05), and the improvement of each index in the observation group was more obvious than that in the control group (P<0.05). Conclusion The combination of conventional western medicine and Modified Huanglian Jiedu Decoction can effectively improve hemodynamic indexes and tissue hypoperfusion level in patients with sepsis of blazing heat-toxin syndrome, providing reference for clinical treatment.