香砂六君子汤对危重症胃肠功能障碍患者疗效及炎性因子的影响  

The curative effect of Xiangshaliujunzi decoction on critically ill patients with gastrointestinal dysfunction and its influence on inflammatory cytokines

作　　者：黄海军[1] 徐华[1] 方一新[1] 金水芳[1] 

机构地区：[1]浙江省中医院下沙院区急诊科,浙江杭州310018

出　　处：《中国中西医结合急救杂志》2016年第5期469-471,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省中医药科技计划科研基金项目（2015ZA081）

摘　　要：目的：观察香砂六君子汤对危重症胃肠功能障碍脾虚证患者的临床疗效及对肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）的影响。方法选择2015年2月至12月浙江省中医院下沙院区急诊重症加强治疗病房（EICU）收治的危重症患者48例，按随机数字表法分为观察组（26例）和对照组（22例）。两组均给予危重症常规西医治疗，观察组在常规治疗基础上加用香砂六君子汤（党参20 g，炒白术12 g，茯苓12 g，炙甘草4 g，法半夏6 g，陈皮5 g，砂仁5 g，木香4 g，生姜3片）浓煎成80 mL，每日分2次鼻饲。对照组以等量温开水鼻饲。记录治疗前、治疗后3 d、5 d患者胃肠功能评分并检测血浆TNF-α、IL-6水平的变化。结果治疗前及治疗3 d两组患者胃肠功能评分和TNF-α及IL-6水平比较差异无统计学意义（均P＞0.05）；治疗后5 d，两组胃肠功能评分、TNF-α及IL-6均明显降低，且观察组的降低程度较对照组更显著〔胃肠功能障碍评分（分）：0.92±0.85比2.27±0.77，TNF-α（ng/L）：17.7±2.4比25.0±4.2，IL-6（ng/L）：16.9±2.4比25.0±3.4，均P＜0.01〕。结论香砂六君子汤对危重症胃肠功能障碍脾虚证患者有治疗作用，其机制可能与降低危重症患者TNF-α及IL-6水平，从而减轻炎症反应有关。ObjectiveTo observe the curative effect of Xiangshaliujunzi decoction on critically ill patients with gastrointestinal dysfunction accompanied by spleen deficiency syndrome of traditional Chinese medicine （TCM） and its influence on tumor necrosis factor-α（TNF-α） and interleukin-6 （IL-6）.Methods Forty-eight critically ill patients admitted to Department of Emergency Intensive Care Unit （EICU） in Zhejiang Provincal Hospital of Traditional Chinese Medicine Xiasha Campus from February to December 2015 were enrolled, and they were randomly divided into observation group （26 cases） and control group （22 cases） by random number table method. The patients in both groups were given routine emergency western therapy, and in the observation group, additionally, Xiangshaliujunzi decoction （ingredients： codonopsis pilosula 20 g, atractylodes macrocephala koidz 12 g, poria cocos 12 g, radix glycyrrhizae preparata 4 g, rhizoma pinelliae preparatum 6 g, pericarpium citri reticulatae 5 g, fructus amomi villosi 5 g, radix aucklandiae 4 g, rhizoma zingiberis recens 3 pieces） 80 mL was prepared and divided into two parts for nasal feeding, once 40 mL, twice a day, while the patients in the control group received the nasal feeding with the same amount of warm boiled water. Before treatment and 3 days and 5 days after treatment, the gastrointestinal function scores were assessed, and the changes of the levels of plasma TNF-α, IL-6 were recorded.Results There were no statistical significant differences in gastrointestinal function scores, the levels of TNF-α and IL-6 between the two groups before treatment and 3 days after treatment （allP ﹥ 0.05）. But 5 days after the treatment, the gastrointestinal function scores, the levels of TNF-α and IL-6 were obviously decreased in two groups, and the degree of decrease in observation group was more significant [gastrointestinal function score： 0.92±0.85 vs. 2.27±0.77, TNF-α （ng/L）： 17.7±2.4 vs. 25.0±4.2, IL-6 （ng/L）： 16.9±2.4 vs. 25.0

关 键 词：香砂六君子汤 危重症 胃肠功能障碍 肿瘤坏死因子-Α 白细胞介素-6 

分 类 号：R725.7[医药卫生—儿科]