中西医结合治疗对急腹症脓毒症患者内毒素及细胞因子的影响  

Effect of Integrated TCM-WM Therapy on Endotoxin and Cytokine of Patients with Acute Abdomen Accompanying Sepsis

作　　者：谢晓华[1] 周文高[1] 程宇星[1] 李小燕[1] 

机构地区：[1]广州中医药大学第一附属医院外科,广州510405

出　　处：《中国中西医结合外科杂志》2006年第4期327-330,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：广东省中医药管理局科研基金项目(099514)

摘　　要：目的探讨中药通腑泻热灌肠剂配合常规外科方法治疗对急腹症并发脓毒症患者血中内毒素及细胞因子的影响和疗效。方法将43例急腹症脓毒症患者随机分为观察组和对照组,分别在常规外科手术及术后处理、抗生素治疗基础上给予通腑泻热灌肠剂和生理盐水灌肠治疗,观察两组治疗前及治疗后第3d、第7d血中内毒素和TNF-α、IL-6、IL-8、IL-2的变化和临床疗效。结果观察组治疗后第3d和第7d血浆内毒素逐步降低,而IL-2逐步升高,与对照组比较P<0.01;第3d血中TNF-α下降与对照组比较P<0.05,IL-6、IL-8下降与对照组比较P<0.01;观察组并发症发生率明显低于对照组,P<0.01。结论中西医结合治疗急腹症脓毒症疗效优于单纯常规治疗,辨证运用中药能降低急腹症脓毒症患者血中内毒素及促炎细胞因子水平,提高与机体免疫功能直接相关的细胞因子,具有免疫调理和减轻全身炎症反应及组织损害作用。Objective To explore the effect of the Chinese herbs Tong Fu Xie Re（通腑泻热） Enema in combination with routine surgical treatment on blood endotoxin and cytokine of patients with acute abdomen accompanying sepsis Methods Forty three patients with acute abdomen accompanying sepsis were divided into the treatment group and the control group at random. On the basis of routine surgical operation , treatment after surgical operation and application of antibiotics, the treatment group was treated with Tong Fu Xie Re Enema, and the control group was treated with saline enema. The changes of endotoxin, TNF - α, IL - 6, IL - 8, and IL - 2 of the two groups before treatment and on the third day and 7^th day after treatment, and clinic therapeutic effect were observed Results On the third day and 7th day after treatment, plasma endotoxin levels of the treatment group was decreased significantly as compared with those of the control group（ P 〈 0.01 ）, with IL - 2 level of the treatment group was increased significantly. The morbidity of the treatment group was lower than that of the control group significantly（P 〈 0.01） Conclusion Integrated traditional Chinese and Western medicine therapy（TCM - WM therapy） was better than single Western medicine therapy in the treatment of acute abdomen accompanying sepsis. The Chinese herbs can decrease blood endotoxin and pminflammatory cytokine levels of patients with acute abdomen accompanying sepsis, increase cytokine level that was related to the immunity function directly, regnlate immunity, reduce the inflammatory reaction and tissue damage, and improve the clinical therapeutic effect.

关 键 词：急腹症 脓毒症 中西医结合疗法 通里攻下法 内毒素 细胞因子 

分 类 号：R656.1[医药卫生—急诊医学]