大承气汤联合益生菌对严重创伤患者血清蛋白的影响  

Effects of Dachengqi Decoction combined with probiotics on serum proteins in patients with severe trauma

作　　者：朱丽娜[1] 付少丽[2] 蒋艳[3] 杨文群[4] 梁泽平[4] 朱京慈[1] 

机构地区：[1]第三军医大学护理学院基础教研室,重庆400038 [2]重庆市中医院护理部,重庆400021 [3]第三军医大学护理学院护理学教研室,重庆400038 [4]第三军医大学大坪医院野战外科研究所重症医学科,重庆400042

出　　处：《重庆医学》2015年第13期1765-1767,共3页Chongqing medicine

摘　　要：目的 探讨大承气汤联合益生菌对严重创伤患者血清蛋白的影响。方法 将2013年4月至2014年6月收治的部位简明损伤定级标准（AIS）≥3分或创伤严重程度评分（ISS）≥16分且无腹部损伤的严重创伤患者70例,按随机数字表法分为单纯肠内营养组（对照组,n=16）、肠内营养＋益生菌组（益生菌组,n=16）、肠内营养＋大承气汤＋益生菌组（联合用药组,n=20）及肠内营养＋大承气汤组（大承气汤组,n=18）;4组患者均于入院后24~72h内经胃管行肠内营养,并于肠内营养第0、4、8、15天清晨通过采集空腹静脉血检测血清总蛋白、清蛋白、前清蛋白、视黄醇结合蛋白、血红蛋白等指标。结果 4组患者在各时间点血红蛋白、清蛋白等差异均无统计学意义（P〉0.05）。视黄醇结合蛋白：联合用药组于肠内营养第4天和15天,含量高于对照组（P〈0.05）;第4天,显著高于大承气汤组（P〈0.01）。总蛋白：第15天,联合用药组含量显著高于对照组,差异有统计学意义（P〈0.01）。前清蛋白：第4天,联合用药组含量增加较其他3组显著（P〈0.05）。结论 大承气汤联合益生菌可通过较好地保护严重创伤患者的胃肠功能,改善血清蛋白水平,两种药物联合使用有协同作用,效果更佳。Objective To investigate the effects of Dachengqi Decoction（DCQT） combined with probiotics on the serum pro- teins in the patients with severe trauma. Methods 70 severe trauma patients （AIS≥3 or ISS≥16） without abdominal injuryin our hospital from April 2013 to June 2014 were randomized into the enteral nutrition group （control group, n = 16）, enteral nutrition ＋ probiotics group （probiotic group, n = 16）, enteral nutrition＋ DCQT ＋ probiotics group （ combined medication group, n = 20） and enteral nutrition＋ DCQT group（DCQT,n= 18） ;the 4 groups received the enteral nutrition via gastric tube within 24--72 h after ad- mission. The indexes of serum total protein,albumin, prealbumin, retinol conjugated protein and hemoglobin were determined by collecting the fasting venous blood on 0,4,8,15 after enteral nutrition. Results There was no statistical differences in hemoglobin and albumin at each time point among 4 groups（P〉0.05）. The retinol conjugated protein level on 4,15 d after enteral nutrition in the combined medication group was higher than that in the blank control group （P〈0.05） ,which on 4 d was significantly higher than that in the DCQT group（P〈0.01）. Total protein on 15 d in the combined medication group was significantly higher than that in the blank control group with statistical difference （P〈0.01）. The increase of prealbumin on 4 d in the combined medicationgroup was obviously higher than that in the other 3 groups （P〈0.05）. Conclusion. DCQT combined with probitics can improve the leve1 of serum proteins in the patients with severe trauma by better protecting the gastrointestinal function. Moreover,the synergetic use of the two drugs achieves the synergistic effect and better outcome.

关 键 词：大承气汤 创伤和损伤 益生菌 肠内营养 血清蛋白 

分 类 号：R641[医药卫生—外科学]