卡巴胆碱联合黄连素治疗创伤后肠功能障碍的临床疗效研究  

Clinical effect of carbachol combined with berberine in the treatment of intestinal dysfunction after trauma

作　　者：徐鑫[1] 孟柠[1] 俞毅君[1] 胡铭荣[1] 

机构地区：[1]杭州师范大学附属医院普外科,杭州310015

出　　处：《中国临床药理学杂志》2016年第7期600-602,共3页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省科技计划基金资助项目(2014C37031)

摘　　要：目的观察卡巴胆碱联合黄连素治疗创伤后肠功能障碍的临床疗效。方法 60例严重创伤患者随机分为试验组和对照组,各30例。对照组经胃管注入卡巴胆碱0.2 mg·kg^(-1),每天2次。试验组在对照组基础上加用生大黄粉20 g,温开水50 mL调匀后经胃管注入,每天2次。2组疗程均为7 d。观察2组患者的临床疗效、多器官功能障碍综合征(MODS)发生率、病死率。分别于治疗前、治疗后晨起对患者进行胃肠功能障碍评分、急性生理及慢性健康状况(APACHEⅡ)评分、MODS评分,测定二胺氧化酶、白细胞介素-6(IL-6)和胃动素水平。结果治疗后,试验组总有效率显著高于对照组(P<0.05)。试验组MODS发生率、病死率均显著低于对照组(P<0.05)。治疗后,试验组胃肠功能障碍评分、APACHEⅡ评分、MODS评分均较对照组显著降低(P<0.05)。治疗后,试验组的二胺氧化酶、IL-6水平较对照组显著降低(P<0.05);试验组的胃动素水平较对照组显著提高(P<0.05)。结论卡巴胆碱联合大黄能明显改善肠功能障碍,特别是肠屏障功能障碍,能抑制炎症反应,取得良好的临床疗效,改善重症患者的预后。Objective To observe the clinical effect of carbachol combined with berberine in the treatment of intestinal dysfunction after trauma. Methods Sixty cases of severe trauma were randomly divided into treatment group（ n = 30） and control group（ n = 30）. Control group was tube injected carbachol 0. 2 mg·kg^-1,2 times a day. Treatment group was tube injected rhubarb powder 20 g and 50 mL water on the basis of control group,2 times a day. The course was 7 d. The clinical efficacy,multiple organ dysfunction syndrome（ MODS） incidence and mortality of the two groups were observed. The gastrointestinal dysfunction score,acute physiology and chronic health evaluation Ⅱ（ APACHE Ⅱ） score,MODS score were observed before treatment and the morning after treatment. Diamine oxidase（ DAO）,interleukin IL-6（ IL-6） and motilin（ MTL） levels were also detected. Results Total effective rate of treatment group was significantly better than that of control group（ P〈0. 05）.After treatment,gastrointestinal dysfunction score,APACHE Ⅱscore and MODS score in treatment group were significantly lower than those of control group（ P〈0. 05）. The levels of DAO and IL-6 of treatmentgroup were significantly lower than those of control group（ P〈0. 05）,but the level of MTL of treatment group was significantly higher than that of control group（ P〈0. 05）. Conclusion Carbachol combined with rhubarb can significantly improve the intestinal dysfunction especially intestinal barrier dysfunction and inhibit inflammatory response so as to achieve good clinical efficacy,and improve the prognosis of patients.

关 键 词：卡巴胆碱 大黄 肠功能障碍 急性生理及慢性健康状况评分 

分 类 号：R971.9[医药卫生—药品]