从“虚”、“瘀”、“毒”论治脓毒症胃肠功能衰竭临床研究  

Clinical Research on Treating Sepsis with Gastrointestinal Failure from Weakness,Static Blood and Toxin

作　　者：王丁超[1] 苏秀平[1] 李亚[2] 高翔[3] 张韧[1] 朱晓飞[1] 陈晓敏[1] 

机构地区：[1]河南省濮阳市中医院 [2]河南省中医学院第一附属医院 [3]河南省中医院

出　　处：《山西中医》2015年第6期15-16,24,共3页Shanxi Journal of Traditional Chinese Medicine

基　　金：河南省教育厅科学技术研究重点项目(编号:13A360594)

摘　　要：目的：观察从＂虚＂、＂瘀＂、＂毒＂论治,采用中药保留灌肠疗法对脓毒症胃肠功能衰竭患者的临床疗效。方法：按照脓毒症及相关诊断标准,选择脓毒症胃肠功能衰竭患者50例,随机分为两组。两组在采用西医综合治疗基础上,治疗组加用扶正败毒逐瘀方保留灌肠,对照组以等量生理盐水灌肠,均为每日2次,7天为1疗程。结果：治疗组总有效率为88.00%（95%CI=68.80%～97.50%）,对照组为76.00%（95%CI=59.26%～92.74%）,两组综合疗效比较（u=2.155 6,P=0.031 2）,差异有显著性意义;两组治疗后14天APACHEⅡ评分参数比较,治疗组低于对照组（t=-5.331 6,P〈0.01）;治疗组具有降低脓毒症患者ARDS、MODS的发生率和降低患者死亡率的优势（但P﹥0.05）。结论：从＂虚＂、＂瘀＂、＂毒＂论治,采用中药保留灌肠疗法治疗脓毒症优于单纯西医疗法的证据尚不够充分,其收益为OR=0.43（95%CI=0.09～1.97）,NNT=8（95%CI=3.00～19.09）。证据揭示,该临床收益可能具有较高度的规模效应。Objective： To observe the clinical effect of retention enema with Chinese medicine on sepsis gastrointestinal failure from weakness,static blood and toxin. Methods： 50 cases of patients with sepsis gastrointestinal failure were selected by sepsis and relevant diagnostic criteria,which were randomly divided into two groups.Western medicine Combined modality therapy were adopted in two groups as basic treatment. Retention enemas of fuzheng baidu zhuyu decoction were added in the treatment group,while the control group was given normal saline enema in equal amounts. All the patients were given the enema 2 times a day,7 days as a course of treatment.Results： The total clinical effective rate of treatment group was 88. 00%（ 95% CI = 68. 80% ～ 97. 50%）,while the control group was 76. 00%（ 95% CI = 59. 26% ～ 92. 74%）,the comprehensive efficacies of two groups were compared（ u = 2. 155 6,P = 0. 031 2）,the difference was statistically significant. The score parameters of APACHEⅡof treatment group were lower than of control group on the 14 thday after the treatment（ t =- 5. 331 6,P〈0. 01）; the treatment group has advantages of reducing incidence of ARDS、MODS and death rate in patients with sepsis gastrointestinal failure（ but P ﹥ 0. 05）. Conclusion： The clinical effect of retention enema with Chinese medicine from weakness,static blood and toxin on sepsis gastrointestinal failure is better than of single western medicine,which has yet not sufficient evidences,its benefits were OR = 0. 43（ 95% CI = 0. 09 ～ 1. 97）,NNT= 8（ 95% CI = 3. 00 ～ 19. 09）. The evidence shows that its benefits were likely to have relatively high scale effect.

关 键 词：脓毒症 胃肠功能衰竭 扶正败毒逐瘀方 灌肠疗法 

分 类 号：R631[医药卫生—外科学]