大黄对重症监护病房危重患者抗生素相关性肠炎预防作用的前瞻性随机对照研究  

Prevention of rhubarb （大黄） from antibiotic-associated colitis in critical patients in intensive care unit： a prospective, randomized controlled clinical study

作　　者：侯杰[1] 邓冲[1] 郭应军[1] 王国军[1] 刘八一[1] 陈华琼[1] 李平[1] 陈侯君[1] 

机构地区：[1]广州中医药大学中山附属中医院ICU,广东中山528400

出　　处：《中国中西医结合急救杂志》2009年第5期272-274,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：基金项目：广东省中山市科技计划项目（20082A053）

摘　　要：目的观察大黄对重症监护病房（ICU）危重患者抗生素相关性肠炎（AAC）的预防作用。方法采用前瞻性随机对照研究方法，将180例人住ICU初次接受抗生素治疗、不伴腹泻且无胃肠道禁忌证的危重患者随机分为治疗组（常规治疗加口服或鼻饲大黄液，91例）及对照组（常规治疗，89例）。采用粪涂片镜检法判断肠道菌群失调情况，比较两组患者接受抗生素治疗7～10d内AAC的发生率及肠道菌群失调和AAC的严重程度。结果180例患者共发生AAC28例，总发生率为15．6％，其中治疗组为13．2％（12／91），较对照组的18．0％（16／89）低，但差异无统计学意义（P〉0．05）；治疗组仅发生1例重度AAC及1例Ⅲ度肠道菌群失调者，较对照组的7例和8例均明显减少，差异均有统计学意义（P均〈0．05）。结论大黄对AAC的预防是有益的，可减少ICU患者AAC，尤其是降低重度AAC及Ⅲ度肠道菌群失调的发生率。Objective To observe the prevention of rhubarb （大黄） from antibiotic-associated colitis （AAC） in critical patients in intensive care unit （ICU）. Methods One hundred and eighty critical patients in ICU without colitis and gastrointestinal contra-indieation were ready to receive initial antibiotic therapy, and prospectively and randomly they were divided into treatment group （taking rhubarb orally or by nasal feeding in addition to routine therapy, 91 eases） and control group （only taking routine therapy, 89 cases）. The incidence of intestinal flora imbalance was diagnosed by stool smear of Gram stain. The incidence and severity of AAC and the degree of intestinal flora imbalance in 7- to 10-day antibiotic treatment in the two groups were compared. Results The total incidence of AAC was 15.6% （28/180） in which 13.2% （12/91） was in treatment group and 18.0% （16/89） in control group （P〉0.05）. There were 1 ease of severe AAC and 1 ease of Ⅲ degree intestinal flora imbalance in treatment group, in contrast, there were 7 severe AAC and 8 Ⅲ degree intestinal flora imbalance cases in control group （both P〈0.05）. Conclusion Rhubarb is beneficial to the prevention of AAC in critical patients in ICU; it can decrease the incidence of AAC, especially the severe AAC and Ⅲ degree intestinal flora imbalance.

关 键 词：大黄 抗生素相关性肠炎 肠道菌群失调 预防 

分 类 号：R285.6[医药卫生—中药学] R574.6[医药卫生—中医学]