小承气汤不同途径给药对老年脓毒症患者胃肠功能障碍的临床研究  

Clinical Study of Different Routes of Administration of Xiaochengqi Decoction on Gastrointestinal Dysfunction in Elderly Sepsis Patients

作　　者：张潇月 李探 邵龙刚[1] 徐敏[1] 魏东梅 彭薇 刘克琴 Zhang Xiaoyue;Li Tan;Shao Longgang(The Second Chinese Medicine Hospital of Jiangsu Province(The Second Affiliated Hospital of Nanjing University of Chinese Medicine),Jiangsu,Nanjing 210017,China.)

机构地区：[1]江苏省第二中医院南京中医药大学第二附属医院

出　　处：《中国中医急症》2019年第8期1420-1422,1434,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省南京市科技项目(201611009)

摘　　要：目的观察中药口服、灌肠及穴位贴敷疗法对老年脓毒症患者胃肠功能障碍的临床疗效。方法将120例老年脓毒症胃肠功能障碍患者随机分为口服组、灌肠组及穴位贴敷组各40例。各组均采用小承气汤组方,口服组和灌肠组均采用煎药机煎制成浓煎剂,穴位贴敷组用大黄∶厚朴∶枳实按1∶2∶1的比例制成药饼贴于神阙穴和中脘穴,每日2次,每次贴敷4 h。检测各组患者治疗前后白细胞计数(WBC)、降钙素原(PCT)、肠功能障碍评分、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分的变化情况,评价各组临床疗效及安全性。结果口服组、灌肠组及穴位贴敷治疗前后WBC、PCT、肠功能障碍评分、APACHEⅡ评分均明显下降(P <0.05);与灌肠组及穴位贴敷组相比口服组各项指标下降速度更为显著(P <0.05)。结论口服中药、中药保留灌肠及穴位贴敷疗法对于老年脓毒症患者胃肠道功能障碍均具有良好疗效,且口服中药优于中药保留灌肠及贴敷疗法。Objective:To explore the clinical effect of oral Chinese medicine,TCM retention enema and acupoint application therapy on gastrointestinal dysfunction in elderly patients with sepsis. Methods:120 patients were randomly divided into three groups:oral group,enema group and acupoint application group,40 cases in each. Each group was treated with Xiaochengqi Decoction,the oral group and enema group were made into thick decoction by decoction machine,and the acupoint application group was treated with rhubarb:Magnolia officinalis:Fructus Aurantii immaturus(1∶2∶1)to make medicine cake affixed to Shenque point and Zhongwan point twice a day for 4 hours each time. The changes of WBC,PCT,intestinal dysfunction score and APACHEⅡ were monitored before and after treatment,and the clinical efficacy and safety of each group were evaluated. Results:WBC,PCT,intestinal dysfunction score and APACHEⅡ score of oral group,enema group and acupoint application group decreased significantly before and after treatment(P < 0.05),and the indexes of oral group decreased more significantly than those of the other two(P < 0.05). Conclusions:Oral Chinese Medicine,retention enema of Chinese medicine and acupoint application therapy have good effects on gastrointestinal dysfunction in elderly patients with sepsis,and oral Chinese medicine is superior to retention enema and application therapy of Chinese medicine.

关 键 词：老年 脓毒症 胃肠功能障碍 中药 不同途径给药 

分 类 号：R631[医药卫生—外科学]