通腑颗粒对多器官功能障碍综合征胃肠功能障碍患者病情严重程度的影响  

Influence of Tongfu granules(通腑颗粒) on the severity of gastrointestinal dysfunction in cases with multiple organ dysfunction syndrome

作　　者：董军[1] 张淑文[2] 段美丽[2] 王宝恩[2] 王红[2] 阴赪宏[2] 文艳[2] 

机构地区：[1]北京大学附属北京肿瘤医院,北京100036 [2]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国中西医结合急救杂志》2006年第6期327-330,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：北京市科委重大课题(H020920050230)

摘　　要：目的：观察通腑颗粒治疗多器官功能障碍综合征（MODS）胃肠功能障碍的临床疗效。方法：采用前瞻性、多中心、临床随机对照研究方法，将140例MODS患者随机分为莫沙必利组和通腑颗粒组，于试验开始时（Oh）以及用药后48h和7d或死亡前对患者进行胃肠功能评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分和Marshall评分;记录患者机械通气时间、住重症监护室（ICU）时间及28d的转归情况。结果：两组治疗后胃肠功能评分、APACHEⅡ评分及Marshall评分均有所降低，且通腑颗粒组较莫沙必利组改善更为明显，差异均有显著性（P〈0．05或P〈0．01）。与莫沙必利组比较，通腑颗粒组机械通气时问明显缩短（P〈0．05）；住ICU时间有所缩短，但差异无显著性。APACHEⅡ≤8分时两组患者病死率均为0，8～20分时差异有显著性，〉20分时差异无显著性。通腑颗粒组28d总病死率较莫沙必利组显著降低（P〈0．05）；且随受累器官数目的增加病死率逐渐增高。结论：通腑颗粒能够改善MODS患者的病情严重度及预后。Objective： To observe the clinical effect of Tongfu granules （通腑颗粒） on the gastrointestinal dysfunction in patientswith multiple organ dysfunction syndrome （MODS）. Methods： The trial was prospective, multi centrie and clinically controlled. One hundred and forty patients with MODS who had been selected were randomly divided into two groups： mosapride citrate group and Tongfu granules group. Respectively at 0 hour, the 48 th hour, the 7 th day or before death, the following scoring systems were calculated： the intestinal dysfunction score, acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score and Marshall score. The duration of mechanical ventilation, hospitalization in intensive care unit （ICU） and the prognosis within 28 days were recorded. Results： After treatments, the intestinal dysfunction score, APACHE Ⅱ score and Marshall score of all patients decreased, at the same time, the therapeutic effects of Tongfu granules group were more significant than those in mosapride citrate group （P〈0.05 or P〈0.01 ）. Compared with the mosapride citrate group, the duration of mechanical ventilation was obviously shortened in Tongfu granules group （P〈0.05）, and the duration of the hospitalization in ICU was also shortened in the latter group, but the difference had no significance. The mortality within 28 days of Tongfu granules group was lowered than that of the mosapride citrate group （P〈0. 05）, but the mortality were both 0 when APACHE Ⅱ≤48 scores, had significant difference when APACHE I between 8 - 20 scores, and had no significant difference when APACHE Ⅱ〉20 scores. The mortality was elevated with the increased number of dysfunction organs. Conclusion： Tongfu granules can ameliorate the severity of the disease situation and improve the prognosis of patients with MODS.

关 键 词：多器官功能障碍综合征 胃肠功能障碍 肠屏障功能 通腑颗粒 预后 

分 类 号：R278[医药卫生—中医学]