观察“通里攻下法”对出血型脑卒中胃肠衰竭的治疗效果  

PURGATIVE THERAPY IN TREATING GASTOINTESTINAL FAILURE IN PATIENTS WITH HEMORRGAGIC STROKE

作　　者：董宁[1] 杨培中[1] 王恩兴[1] 刘向东[1] 

机构地区：[1]临沂市中医医院,山东临沂276002

出　　处：《山东医学高等专科学校学报》2007年第4期301-303,共3页Journal of Shandong Medical College

摘　　要：目的 观察“通里攻下法”对出血型脑卒中胃肠衰竭的临床治疗效果.方法 选择符合纳入标准的出血型脑卒中58例,GCS评分5～8分.随机分为治疗组和对照组.比较两组患者胃肠衰竭的发生率、肠麻痹缓解率、72 h后肠鸣音的变化率,治疗后胃液pH值变化、血浆TNF-α、IL-6 含量等.结果 治疗组胃肠衰竭的发生率（30%）、治疗组中毒性肠麻痹的缓解率（76.6%）及72 h后肠鸣音的变化率（80%）均高于对照组（P＜0.01）.治疗组治疗后胃液pH值呈升高趋势（F=315.86,P＜0.01）,入院2、6 d胃液pH值均高于对照组（P＜0.01）.对照组各时点胃液pH值变化无统计学意义（F=0.1,P＞0.05）.治疗后治疗组的血清TNF-α、IL-6含量均低于对照组（P＜0.01）.结论 “通里攻下法” 对防治出血型脑卒中胃肠衰竭是一种疗效较好的方法.Objective To study the curative effects of purgative therapy in treating gastrointestinal failure in patients of hemorrhagic stroke. Methods 58 cases of hemorrhagic stroke with the GCS scores being 5 -8 were randomly divided into the treatment group and the contrast group. Comparisons were made in terms of the occurrence rate of gastrointestinal failure, the remission rate of enteroparalysis, the changes of bowel sounds after 72 hours, the changes in pH value of gastric juice and the contents of TNF-α and Il-6. Results The occurrence rates of gastrointestinal failure in the treatment group and the contrast group were 30 % and 82.14 % respectively（ P 〈 0.01 ）, The remission rate and the changing rate of the treatment rate after 72 hours of treatment were 76, 6 % and 80% respectively,both of which were higher than those of the contrast group（ P 〈0.01）. The pH value rose steadily（ F = 315.86, P 〈0.01） in the treatment group and higher than the contrast group on the 2nd and 6th day of treatment,while the pH value showed no significant changes（ F = 0.1, P 〉0.05）. The contents of TNF-α and Il-6 in the treatment group were both lower than those in the contrast group（ P 〈0.01）. Conclusion Purgative therapy has proved to be an effective method of preventing gastrointestinal failure in patients of hemorrhagic stroke.

关 键 词：通里攻下法 出血型脑卒中 胃肠衰竭 

分 类 号：R743[医药卫生—神经病学与精神病学]