中药组方联合连续血液灌流治疗百草枯中毒的疗效分析*

Efficacy analysis of Chinese herbal formulas combined with continuous hemoperfusionon acute paraquat poisoning*

摘要:

目的 观察中药组方联合连续血液灌流对百草枯（PQ）中毒患者的疗效。方法 将108例PQ中毒患者分为对照组（常规药物和连续血液灌流治疗）和治疗组（在对照组基础上加中药组方），治疗24?h，两组均给予持续静脉-静脉血液滤过（CVVH）。两组均于治疗前及治疗3和7?d，检测血Lac、Presepsin、血尿素氮（BUN）、肌酸激酶（CK）和急性生理学和慢性健康状况评估Ⅱ（APACHEⅡ）评分的变化，于治疗前及治疗8及12?h检测血中PQ浓度，记录两组患者28?d生存情况。结果 两组患者不同时间点Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度有差异（P?<0.05）；对照组和治疗组Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度有差异（P?<0.05），治疗组与对照组比较，治疗后Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度比较低，相对治疗效果好；对照组和治疗组Lac、Presepsin、BUN、CK、APACHEⅡ评分和PQ浓度变化趋势有差异（P?<0.05）。治疗组28?d病死率（44.44%，24/54）低于对照组（66.67%，36/54）（P?<0.05）。结论 中药组方联合连续血液灌流能降低百草枯中毒患者Lac、Presepsin、BUN、CK和APACHEⅡ评分，提高患者生存率，疗效良好，值得临床推广应用。

Abstract:

Objective To observe the efficacy of Chinese herbal formulas combined with continuous hemoperfusion on acute paraquat (PQ) poisoning. Methods Totally 108 PQ patients were divided into control group (standard treatment including continuous hemoperfusion) and therapy group (receiving additional Chinese herbal formulas). Both groups were treated for 24h. Continuous intravenous-venous hemofiltration (CVVH) was administered. Blood Lac, Presepsin, blood urea nitrogen (BUN), creatine kinase (CK), and acute physiology and chronic health assessment II (apache II) scores were measured in both groups before treatment and 3 and 7 days of treatment. Furthermore, 28-day survival was recorded before treatment, 8 h and 12 h after treatment. The prognostic value of blood Lac and Presepsin levels was analyzed. Results Treatments induced a significant decrease of Lac, Presepsin, BUN, CK, APACHE II score, and PQ when compared with those prior to any treatments (P?