张宇 梁志锋 徐象辉

【摘要】 目的：探討脓毒症凝血功能障碍患者采用犀角地黄汤联合西药治疗对其凝血指标、临床疗效的影响，并对患者的预后情况进行分析。方法：随机选取2016年5月-2018年6月来本院接受治疗的脓毒症凝血功能障碍患者48例作为此次临床研究对象，根据治疗方法将其分为对照组和观察组，每组各24例。对照组采用单纯西药治疗，观察组采用犀角地黄汤联合西药治疗，观察两组凝血指标、临床疗效、生活质量及对治疗的满意度。结果：治疗前，两组凝血指标比较，差异均无统计学意义（P>0.05）;治疗后，观察组PLT和FIB水平均明显高于对照组，PT和APTT均明显短于对照组，D-D水平明显低于对照组，差异均有统计学意义（P<0.05）。观察组临床治疗效果、生活质量及对治疗的满意度和对照组相比，差异均有统计学意义（P<0.05）。结论：脓毒症凝血功能障碍患者采用犀角地黄汤联合西药治疗可明显改善患者的凝血指标，提高临床疗效和生活质量，从而提高其对治疗的满意度。

【关键词】 犀角地黄汤; 西药; 脓毒症; 凝血功能障碍; 临床疗效; 凝血指标

【Abstract】 Objective：To investigate the effect of Xijiao Dihuang Decoction combined with western medicine on coagulation index and clinical efficacy of sepsis patients with coagulation dysfunction，and to analyze the prognosis of patients.Method：A total of 48 sepsis patients with coagulation dysfunction who treated in our hospital from May 2016 to June 2018 were randomly selected as the experimental subjects in this clinical study.According to different clinical treatment methods，they were divided into two groups，24 cases in each group.The patients in the control group were treated with simple western medicine，the patients in the observation group were treated with Xijiao Dihuang Decoction combined with western medicine.The coagulation index，clinical efficacy，quality of life and satisfaction with treatment of two groups were observed.Result：Before treatment，there were no significant differences in coagulation indexes between two groups（P>0.05）.After treatment，the levels of PLT and FIB in the observation group were significantly higher than those in the control group，and PT and APTT were significantly shorter than those of the control group，the level of D-D was significantly lower than that of the control group，and the differences were statistically significant（P<0.05）.The clinical treatment effect，quality of life and satisfaction of treatment in the observation group compared with the control group were statistically significant（P<0.05）.Conclusion：Xijiao Dihuang Decoction combined with western medicine can significantly improve the coagulation indexes，clinical efficacy and quality of life of sepsis patients with coagulation dysfunction，so as to improve their satisfaction with the treatment.

【Key words】 Xijiao Dihuang Decoction; Western medicine; Sepsis; Coagulation dysfunction; Clinical effect; Coagulation index

First-authors address：Shenzhen Baoan Chinese Medicine Hospital（Group），Shenzhen 518000，China

doi：10.3969/j.issn.1674-4985.2019.16.030

脓毒症最初的概念是全身炎症反应综合征，但近年来这一概念的合理性受到了质疑[1]。脓毒症是现在临床上发现的早期激活应答反应，即可促炎又可抗炎，在临床中的发生率极高，全球每年平均有超过1 800万的严重脓毒症病例，脓毒症病情凶险，常并发水电解质紊乱、酸碱平衡失调、深静脉血栓、弥散性血管内凝血等并发症，且病死率相对较高，大多患者死于多器官功能障碍综合征等并发症[2]。根据流行病学调查显示[3]，脓毒症在临床中的病死率已经超过了心肌梗死，成为重症监护室内非心脏病患者死亡的重要原因。近年来，虽然临床中关于抗感染治疗的药物和用于器官功能支持的技术在不断进步，但脓毒症的病死率在临床中依然可达30%～70%[4-5]。临床……