四逆汤对阳气亏虚证脓毒症患者急性肾损伤的疗效分析

Curative Effect of Sini Decoction on Acute Kidney Injury in Patients with Sepsis of Yang Qi Deficiency Syndrome

摘要: 目的：回顾性分析观察阳气亏虚证脓毒症相关急性肾损伤(SA-AKI)患者使用四逆汤后的临床疗效，探讨四逆汤能否改善患者肾功能，以及改善死亡率。方法：对2018年5月至2021年5月住院重症监护病房患者进行检索，共检索到90例患者。根据是否服用四逆汤将他们分为两组。对照组(40例)给予SA-AKI常规西医治疗，治疗组(50例)，在西医治疗的基础上加用中医治疗，即服用四逆汤。观察两组治疗7天后患者脓毒症相关评分，即Apache Ⅱ评分、SOFA评分，中医证候积分，相关肾功能指标：血肌酐、血尿素氮、24小时尿量，相关炎症指标：C反应蛋白、降钙素原、白细胞计数的情况。结果：1) 治疗组的相关评分、炎症指标、中医证候积分明显优于对照组(P < 0.05)。2) 治疗组的肌酐、尿素氮、24小时尿量均优于对照组(P < 0.05)。3) 两组对比患者30天死亡率较对照组无显著性差异(P > 0.05)。结论：对于SA-AKI患者服用四逆汤后能明显改善患者的肾功能，但是对患者30天内死亡率无改变。

Abstract: To retrospectively analyze and observe the clinical efficacy of Sini Decoction in patients with sepsis-associated acute kidney injury (SA-AKI) of Yang Qi deficiency syndrome, and to explore whether Sini Decoction can improve patients’ renal function and reduce mortality. Methods: We retrieved data on a total of 90 patients admitted to the intensive care unit between May 2018 and May 2021. These patients were divided into two groups based on whether they received Sini Decoction. The control group (40 cases) received conventional Western medicine treatment for SA-AKI, while the treatment group (50 cases) received traditional Chinese medicine treatment in addition to Western medicine, specifically Sini Decoction. After 7 days of treatment, we observed various parameters in both groups, including sepsis-related scores (Apache Ⅱ score and SOFA score), TCM syndrome scores, renal function indicators (blood creatinine, blood urea nitrogen, and 24-hour urine output), and inflammatory markers (C-reactive protein, procalcitonin, and white blood cell count). Results: 1) The treatment group exhibited significantly better scores in the relevant parameters, inflammatory indicators, and TCM syndrome scores compared to the control group (P < 0.05). 2) The treatment group demonstrated superior results in terms of creatinine, urea nitrogen, and 24-hour urine output compared to the control group (P < 0.05). 3) No significant difference was observed in the 30-day mortality rate between the two groups (P > 0.05). Conclusion: Sini Decoction can significantly improve renal function in patients with SA-AKI, but it does not affect the 30-day mortality rate.