肉桂粉穴位贴敷联合西医常规疗法治疗脾阳虚型脓毒症胃肠功能障碍的临床研究  

Clinical study on the treatment of gastrointestinal dysfunction of spleen yang deficiency type sepsis by acupoint application of cinnamon powder combined with conventional western medicine therapy

作　　者：陈红[1,2] 欧阳红莲 潘卫红 张广清 CHEN Hong;OUYANG Honglian;PAN Weihong;ZHANG Guangqing(College of Nursing,Hunan University of Traditional Chinese Medicine,Changsha 410208,China;Department of Critical Medicine,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Southern Hospital of Southern Medical University,Guangzhou 510515,China)

机构地区：[1]湖南中医药大学护理学院,湖南长沙410208 [2]广州中医药大学第二附属医院重症医学科,广东广州510006 [3]南方医科大学南方医院,广东广州510515

出　　处：《上海中医药杂志》2020年第4期80-84,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：广东省中医药管理局资助项目(20170218)

摘　　要：目的观察肉桂粉穴位贴敷联合西医常规疗法治疗脾阳虚型脓毒症胃肠功能障碍的临床疗效。方法将90例脾阳虚型脓毒症胃肠功能障碍患者随机分为治疗组、对照组,每组45例。对照组给予西医常规治疗,治疗组在对照组治疗措施的基础上加用肉桂粉穴位贴敷。两组均连续治疗7 d,比较胃肠功能障碍评分、肠鸣音评分、腹围、腹内压、平均胃潴留量、急性胃肠损伤(AGI)分级、急性生理功能和慢性健康状况评分Ⅱ(APACHEⅡ)、中医证候积分、实验室相关指标[血清白细胞(WBC)、降钙素原(PCT)]的变化情况,随访多器官功能障碍综合征(MODS)发生率、28 d病死率。结果①试验期间,对照组脱落1例,治疗组脱落2例,最终完成试验者87例,其中对照组44例,治疗组43例。②治疗前后组内比较,两组胃肠功能障碍评分、肠鸣音评分、腹围、腹内压、平均胃潴留量较治疗前减少(P<0.05);组间治疗后比较,治疗组胃肠功能障碍评分、肠鸣音评分、腹围、腹内压、平均胃潴留量少于对照组(P<0.05)。③治疗前后组内比较,两组的AGI分级情况均较治疗前有所改善(P<0.05);组间治疗后比较,治疗组AGI分级情况好于对照组(P<0.05)。④治疗前后组内比较,两组的APACHEⅡ评分、中医证候积分均较治疗前减少(P<0.05);组间治疗后比较,治疗组APACHEⅡ评分、中医证候积分少于对照组(P<0.05)。⑤治疗前后组内比较,两组的血清WBC、PCT水平均较治疗前下降(P<0.05);组间治疗后比较,治疗组血清WBC、PCT水平低于对照组(P<0.05)。⑥治疗组、对照组MODS发生率分别为7.0%、22.7%,治疗组MODS发生率低于对照组(P<0.05);治疗组、对照组28 d病死率分别为18.6%、25.0%,差异无统计学意义(P>0.05)。结论与西医常规疗法相比,肉桂粉穴位贴敷联合西医常规疗法可以更好地改善脾阳虚型脓毒症胃肠功能障碍患者的胃肠功能,改善病情,控制炎症反应,降�Objective To observe the clinical effect of acupoint application of cinnamon powder combined with conventional western medicine on gastrointestinal dysfunction in patients with spleen yang deficiency sepsis.Methods Ninety patients with gastrointestinal dysfunction of spleen yang deficiency sepsis were randomly divided into treatment group and control group,45 cases in each group.The control group was given conventional western medicine treatment,and the treatment group was given cinnamon powder acupoint application besides the treatment measures of the control group.The two groups were treated for 7 days continuously.The changes of gastrointestinal dysfunction score,bowel sound score,abdominal circumference,intra-abdominal pressure,mean gastric retention volume,acute gastrointestinal injury(AGI)grade,acute physiology function and APACHE II score,TCM syndrome score,laboratory correlation index[WBC and PCT]were observed and compared.The incidence of multiple organ dysfunction syndrome(MODS)and28-day mortality were followed up.Results(1)During the experiment,1 case dropped out in the control group,2 cases dropped out in the treatment group and 87 cases in total completed the experiment,including 44 cases in the control group and 43 cases in the treatment group.(2)After treatment,the gastrointestinal dysfunction score,bowel sound score,abdominal circumference,intra-abdominal pressure and mean gastric retention volume of both groups decreased compared with those before treatment(P<0.05).After treatment,the gastrointestinal dysfunction score,bowel sound score,abdominal circumference,intra-abdominal pressure and mean gastric retention volume in the treatment group were lower than those in the control group(P<0.05).(3)After treatment,there was improvement of the AGI grade in both groups(P<0.05);after treatment,the AGI grade of the treatment group was better than that of the control group(P<0.05).(4)After treatment,the scores of ApacheⅡand TCM syndrome in the two groups both decreased(P<0.05);the scores of ApacheⅡand

关 键 词：脓毒症 胃肠功能障碍 脾阳虚 肉桂 穴位贴敷 中西医结合疗法 多器官功能障碍综合征 

分 类 号：R459.7[医药卫生—急诊医学] R57[医药卫生—治疗学]