泄瘀通腑汤治疗老年创伤性休克临床研究  

Clinical Observation on Xieyu Tongfu Decoction on Traumatic Shock in elderly Patients

作　　者：邢元丽[1] 周硕霞[1] 初海滨[1] 

机构地区：[1]山东省威海市文登整骨医院,山东威海264400

出　　处：《中国中医急症》2018年第2期237-239,252,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：山东省科技发展计划项目(2015YD19008)

摘　　要：目的观察泄瘀通腑汤治疗老年创伤性休克临床疗效及对其血浆降钙素原(PCT)、氨基末端脑钠肽前体(NT-pro-BNP)和胃肠功能恢复的影响。方法将患者130例按随机数字表法分为对照组62例与观察组68例。对照组给予补液复苏治疗,观察组在对照组基础上给予泄瘀通腑汤治疗。比较两组治疗前后临床症状、病情严重程度(APACHEⅡ评分)、血浆PCT及NT-pro-BNP水平、胃肠功能恢复情况及生活质量(SF-36评分),并评价两组临床疗效及安全性。结果与治疗前相比,治疗后两组中医症状积分、APACHEⅡ评分及血浆PCT、NT-pro-BNP水平均下降,而SF-36评分均升高,且观察组上述指标在治疗后均优于对照组(P<0.01);治疗后,观察组肠鸣音恢复时间、肛门首次排气时间及排便时间均短于对照组,而排便次数多于对照组(P<0.01);观察组临床疗效总有效率为94.12%,优于对照组之80.65%(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论泄瘀通腑汤治疗老年创伤性休克,可有效降低血浆PCT、NT-pro-BNP水平,促进胃肠功能恢复,缓解临床症状,并提高患者生活质量,临床疗效显著,不良反应亦少。Objective： To explore the clinical efficacy of Xieyu Ton^Cu Decoction on elderly patients with trau- matic shock and influence on PCT,NT-pro-BNP and gastrointestinal function recovery. Methods： 130 cases were selected as the study objects, and divided into two groups according to random number table method ,the control group 62 cases and the observation group 68 cases. The control group were given routine anti-shock treat- ment,and the observation group were given Xieyu Ton^Cu Decoction treatment on the basis of the control group. Clinical symptoms, the severity of disease （APACHE I1 score）, plasma PCT and NT-pro-BNP levels, gastrointesti- nal function recovery and quality of. life （SF-36 score） were compared, and clinical efficacy and safety were eval- uated in the two groups. Results： Compared with those before treatment,TCM symptom scores,APACHE I1 score and plasma PCT, NT-pro-BNP levels decreased after treatment,while SF-36 scores increased, and the above in- dicators of the observation group after treatment were better than those in the control group,with statistically sig- nificant difference（P〈O.O1 ）. After treatment,borborygmus recovery time,anal exhaust time and defecation time in the observation group were lower than those in the control group, and defecation times was higher than that in the control group,with statistically significant difference （P〈 0.01 ）. Total effective rate of the observation group was 94.12%, better than that of the control group （80.65%）, with statistically significant difference （P 〈 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P〉 0.05）. Conclusion： Xieyu Tongfu Decoction can effectively reduce plasma PCT and NT-pro-BNP levels,promote the recovery of gas- trointestinal function ,alleviate clinical symptoms and improve quality of life of elderly patients with traumatic shock, with remarkable clinical effect and few side effects, worthy of clinical promotion.

关 键 词：老年创伤性休克 泄瘀通腑汤 降钙素原 脑钠肽前体 胃肠功能 

分 类 号：R605.971[医药卫生—急诊医学]