大黄对脓毒症患者血清新喋呤影响的研究  

Clinical study of the effect of rhubarb on serum neopterin levels in the patients with sepsis

作　　者：龚梅金 卢卫 卢君强 罗鹏 幸泽茂 

机构地区：[1]深圳市西丽人民医院内科,广东518055 [2]深圳市第六人民医院

出　　处：《中国急救医学》2009年第3期249-251,共3页Chinese Journal of Critical Care Medicine

基　　金：广东省中医药管理局科研立项课题（No.2007498）

摘　　要：目的观察大黄对脓毒症患者血清新喋呤的影响，进一步探讨其治疗脓毒症的作用机制。方法40例脓毒症合并中毒性肠麻痹患者，随机分为两组，大黄治疗组和对照组各20例。对照组采用综合治疗，大黄治疗组在综合治疗的基础上加用大黄。观察两组患者治疗前后血清新喋呤水平的变化、中毒性肠麻痹的缓解率以及14d生存率。结果两组患者血清新喋呤在24h后明显升高，大黄治疗组在24、48及72h血清新喋呤水平较对照组明显降低（P〈0．01）。大黄治疗组在治疗后48h及72h中毒性肠麻痹的缓解率分别为50％和75％，与对照组比较差异有统计学意义（P〈0．05和P〈0．01）。14d生存率明显高于对照组（P〈0．05）。结论大黄能有效缓解脓毒症患者中毒性肠麻痹，改善胃肠功能，降低血清中新喋呤水平，拮抗系统炎症反应，提高患者的生存率。Objective To explore the therapeutic mechanism of rhubarb in the treatment of the patients with sepsis by observing its curative effect on serum neopterin levels in septic patient. Methods 40 septic patients with toxic paralytic ileus were randomly divided into two groups. The 20 patients in the control group were treated with combined treatment and the 20 cases in the rhubarb group treated with combined treatment plus rhubarb. The changes of neopterin, gut peristalsis and 14 - day survival rate were monitored and compared. Results Compared with the control group, the levels of neopterin was significantly lower on 24, 48, and 72 hours after rhubarb administration in the rhubarb group （ P 〈 0.01 ）. In the rhubarb group, 50% and 75% of patients recovered from toxic paralytic ileus on 48 and 72 hours after rhubarb intake, and there were significant differences between the rhubarb group and the control group （P 〈0.05 and P 〈0.01 ）. The 14 -day survival rate in the rhubarb group was much higher than that in the control group（P 〈 0.05 ）. Conclusions Rhubarb can effectively relieve toxic paralytic ileus and reduce the serum levels of neopterin in septic patients, and also obviously improves the survival rate of septic patients.

关 键 词：大黄 脓毒症 肠麻痹 新喋呤 

分 类 号：R515.3[医药卫生—内科学]