复方大承气汤联合乌司他丁治疗ICU脓毒症患者肠功能障碍的临床观察  

C linical Research of Dachengqi Decoction Combined with Ulinastatin on Intestinal Dysfunction in ICU Patients with Sepsis

作　　者：毛诗昊[1] 江荣林[1] 王灵聪[1] 

机构地区：[1]浙江省中医院,浙江杭州310006

出　　处：《中国中医急症》2016年第4期688-690,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：浙江省科技计划项目(2014C37031)

摘　　要：目的观察复方大承气汤联合乌司他丁治疗ICU脓毒症患者肠功能障碍的临床疗效及安全性。方法将ICU脓毒症患者伴肠功能障碍96例按随机数字表法分为对照组和治疗组,各48例。对照组患者口服复方大承气汤,并每日2次保留灌肠,共7 d。治疗组在对照组用药的基础上给予静脉滴注乌司他丁,每日3次,疗程7 d。观察两组患者的临床疗效、肠内营养耐受率、DOA及D-乳酸浓度。结果治疗组和对照组患者的第5日的肠功能评分别为(0.486±0.313)分和(0.635±0.364)分,差异具有统计学意义(P<0.05)。治疗组和对照组患者的第7日的肠功能评分别为(0.216±0.354)分和(0.425±0.367)分,差异具有统计学意义(P<0.05)。治疗组和对照组患者第7日的肠内营养耐受率分别为85.42%和70.83%,差异具有统计学意义(P<0.05)。治疗组第7日的DAO活性剂D-乳酸浓度分别为(2.02±0.17)U/m L、(1.09±0.13)mg/L,显著低于对照组第7日的(2.48±0.35)U/m L、(1.28±0.18)mg/L(P<0.05)。两组患者药物反应发生率分别为14.58%和10.42%,差异无统计学意义(P>0.05)。结论复方大承气汤联合乌司他丁治疗ICU脓毒症患者肠功能障碍临床疗效明显,无明显不良反应。Objective：To investigate the clinical effects and adversereations of Dachengqi decoction combined with ulinastatin on intestinal dysfunction in sepsis patients.Methods：A total of 96 sepsis patients with intestinal dysfunction were recruited and randomized divided into the treatment group and the control group,48 cases in each.The control group were treated by Dachengqi decoction（100 m L,two times daily）for 7 days.The treatment group were given 2×105ulinastatin intravenous drip,3 times a day combined with Dachengqi decoction.Treatment course was 7 days.The data of clinical efficacy,the score of intestinal function and the rate of enteral nutrition tolerance,the blood plasma levels of diamine oxidase（DAO）activity and D-lactate concentration between the two groups were compared.Results：The scores of intestinal function were（0.486±0.313）and（0.635±0.364）in the treatment and control group,respectively on 5th day,indicating significant statistical difference between the two groups（P〈0.05）;the scores of intestinal function were（0.216±0.354）in the treatment group and（0.216±0.354）in the treatment group respectively on 7th day,with significant differences（P〈0.05）.The rate of enteral nutrition tolerance in the treatment group was（85.42%）higher than the control group（70.83%）,with significant differences in two groups on 7th day（P〈0.05）.Compared with the control group,DAO activity and D-lactate concentration in the treatment group were（2.02±0.17）and（1.09±0.13）significantly lower than the control group on 7th day（P〈0.05）.The adverse drug reactions was 14.58% vs 10.42% respectively.There was no significant difference in two groups（P〉0.05）.Conclusion：Dachengqi decoction combined with ulinastatin can quickly improve the symptoms of intestinal dysfunction in sepsis patients,without increasing adverse reactions.

关 键 词：复方大承气汤 乌司他丁 脓毒症 肠功能障碍 临床疗效 

分 类 号：R375.2[医药卫生—病原生物学] R72[医药卫生—基础医学]