氢化可的松片治疗效果怎么样

Judging from the results of previous experimental studies, (hydrocortisone) has a relatively obvious therapeutic effect on patients, and patients can also benefit a lot from it through continued treatment.

Based on the purpose of providing the body with a cortisol concentration that is more in line with physiological levels while minimizing drug side effects, a clinical randomized controlled trial has been conducted to study this. In the trial, the dose of corticosteroids was adjusted from a high dose to a medium dose (200-300mg/D). The results of a meta-analysis of these 6 studies showed that the use of hydrocortisone can significantly correct severe shock, but does not improve the mortality rate.

One of the double-blind, randomized, placebo-controlled, multi-center research projects across Europe is worthy of attention. A total of 500 patients with septic shock were enrolled in the study. Patients in the experimental group were treated with hydrocortisone, 50 mg intravenously q6h for 5 days, then 50 mg q12h for 3 days, and then 50 mg qd for 3 days. The conclusion is that septic shock that is poorly treated by fluid resuscitation and vasoactive drugs, regardless of whether it responds to ACTH stimulation, can be treated with low-dose hydrocortisone. Although the improvement in mortality is unclear, it can correct shock faster. There is also evidence that the use of hydrocortisone in patients with septic shock can reduce the occurrence of post-traumatic stress disorder and improve the mental state of patients recovering from shock.

Foreign studies have also conducted studies on the effects of low-dose corticosteroids in patients with cirrhosis and septic shock. In this prospective study, 25 patients with cirrhosis and septic shock were treated with hydrocortisone. The diagnostic criteria for adrenal insufficiency in this study were basal cortisol <414 nmol/L (16.5 ug/dL), or an increase in cortisol concentration <248 nmol/L (10 ug/dL) in patients whose basal cortisol concentration was less than 966 nmol/L (39.6 ug/dL) after SST.

The results show that 18/25 (68%) of the above-mentioned study subjects have adrenal insufficiency. These patients can recover from shock quickly after treatment. Compared with those historical controls who have not undergone adrenal function experiments, the survival rate is significantly improved.

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