通腑泻下法干预危重症患者胃肠功能障碍的临床研究  

Intervention to gastrointestinal dysfunction and failure with therapy of relaxing bowels and purgation in critical patients

作　　者：张翔炜[1] 张敏州[1] 翁燕娜[1] 李芳[1] 吴巧媚[1] 张晓璇[1] 韩云[1] 

机构地区：[1]广东省中医院重症监护室,广东510120

出　　处：《北京中医药大学学报》2011年第10期707-710,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：广州中医药大学中医药科研创新基金资助项目(No.2007C073)

摘　　要：目的观察通腑泻下中药灌肠对危重症患者胃肠功能障碍(GIDF)的影响并探讨其机制。方法将74例危重症患者随机分为对照组及治疗组各37例。其中治疗组女14例,男23例,平均年龄(71.76±11.93)岁,对照组女17例,男20例,平均年龄(72.76±11.24)岁,2组患者的一般资料经对比差异均无统计学意义(P<0.05),具有可比性。对照组采用西药常规病因及对症治疗,治疗组在对照组治疗基础上按辨证加用通腑泻下中药灌肠,2组疗程均为5 d,观察治疗前后2组患者二胺氧化酶(DAO)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、C-反应蛋白(CRP)及胃肠功能障碍的变化。结果治疗后2组DAO、TNF-α、IL-6、CRP均有所下降,治疗后2组DAO、TNF-α、IL-6比较,差异有统计学意义(P<0.05),CRP比较差异无统计学意义(P>0.05);治疗后治疗组的胃肠功能改善明显优于对照组。结论以通腑泻下中药煎剂灌肠能改善患者胃肠功能障碍,其机制与降低危重症患者DAO、TNF-α、IL-6、CRP等相关。Objective To observe the influence of enema therapy with Chinese medicinal with the actions of relaxing bowels and purgation on gastrointestinal dysfunction and failure （GIDF） in critical patients and to study the mechanism. Methods All critical patients （ n = 74） were randomly divided into the control group and treatment group （each n = 37）. In the treatment group there were 14 female patients and 23 male ones and the average age was （71.76 ± 11.93） years old. In the control group there were 17 female patients and 20 male ones and the average age was （72.76 ± 11.24） years old. The comparison of general materials between two groups showed that the difference was not statistically significant （ P 〈 0.05 ）. The control group was given symptomatic treatment of Western medicine, and the treatment group, retention enema of Chinese medicinal with the actions of relaxing bowels and purgation according to syndrome differentiation besides the same treatment as the control group. A therapeutic course was for 5 days. The changes of diamine oxidase （DAO） , tumor necrosis factor-α （ TNF-α ）, interleukin-6 （ IL-6 ）, C-reactive protein （ CRP ） and gastrointestinal function were observed in two groups before and after the treatment. Results The levels of DAO, TNF-α, IL-6 and CRP decreased in two groups after the treatment. The comparison of DAO, TNF-α and IL-6 between two groups after the treatment showed that the difference was statistically significant （ P 〈 0.05 ）, and comparison of CRP showed that the difference was not statistically significant （P 〉 0. 05 ）. The improvement of gastrointestinal function in the treatment group was better than that in the control group. Conclusion The enema therapy with Chinese medicinal with the actions of relaxing bowels and purgation can abate GIDF, and the mechanism may be related to the decrease of DAO, TNF-α, IL-6 and CRP levels.

关 键 词：通腑泻下法 灌肠 危重症 胃肠功能障碍 

分 类 号：R256.3[医药卫生—中医内科学]