大承气汤对严重脓毒症并腹腔间隔室综合征患者抑炎因子的影响  

Effect of Dachengqi Decoction on Anti-inflammatory Factors in Patients with Severe Pyemia and Abdominal Compartment Syndrome

作　　者：李长辉[1] 袁硕 白雪松[1] 冯伟[2] 李景栋[2] LI Changhui;YUAN Shuo;BAI Xuesong;FENG Wei;LI Jingdong(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;The 4TH People's Hospital of Shenyang,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032 [2]沈阳市第四人民医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2019年第8期118-121,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省科学技术计划项目(2012225018)

摘　　要：目的:观察大承气汤对脓毒症并腹腔间隔室综合征患者抑炎因子的影响。方法:54例患者按发生腹腔间隔室综合征的先后顺序,按照事先由随机数确定的随机分组方法,进入治疗组和对照组。治疗组在西药治疗原发病基础上,入组后予口服大承气汤治疗。比较两组治疗前后APACHEⅡ评分,C反应蛋白水平,血清抑炎因子IL-4、IL-10、IL-13表达水平以及动脉血氧合指数、二氧化碳分压。结果:治疗组与对照组治疗后APACHEII评分较治疗前降低,治疗组较对照组改变更明显(P<0.05);治疗组与对照组治疗后C反应蛋白水平下降,治疗组较对照组改变更明显(P<0.05);治疗组与对照组治疗后血清抑炎因子IL-4、IL-10、IL-13表达水平均升高,治疗组较对照组改变更明显(P<0.05);两组腹腔内压较治疗前降低,腹腔灌注压较治疗前升高,与治疗前比较,差异有统计学意义(P<0.05);治疗组较对照组改变更明显(P<0.05);治疗组与对照组治疗后动脉血氧合指数上升,二氧化碳分压下降,与治疗前比较,差异有统计学意义(P<0.05);治疗组较对照组改变更明显(P<0.05)。结论:应用大承气汤治疗脓毒症并腹腔间隔室综合征有效,其药理作用可能与促进抑炎因子释放有关。Objective:To observe the effect of Dachengqi Decoction on anti-inflammatory factors in patients with pyemia and abdominal compartment syndrome.Methods:54 patients were assigned to the treatment group and the control group according to the sequence of occurrence of abdominal compartment syndrome by the means of random grouping determined by random numbers in advance.On the basis of the primary disease of Western medicine treatment,the treatment group was treated with oral Dachengqi Decoction.The APACHE II score,C-reactive protein level,serum anti-inflammatory factors IL-4,IL-10,IL-13 expression levels,arterial oxygenation index and carbon dioxide partial pressure were compared before and after treatment.Results:The APACHE II scores in the treatment group and the control group were lower than those before treatment,and the treatment group was more obvious than the control group(P<0.05).The levels of C-reactive protein decreased in the treatment group and the control group,and the treatment group changed more significantly than the control group(P<0.05).The levels of serum antiinflammatory factors IL-4,IL-10 and IL-13 increased after treatment in the treatment group and the control group,and the treatment group changed more significantly than the control group(P<0.05).The intraabdominal pressure of the two groups was lower than that before treatment,and the peritoneal perfusion pressure was higher than that before treatment.The difference was statistically significant(P<0.05).The treatment group was more obvious than the control group(P<0.05);After treatment,the arterial blood oxygenation index increased and the carbon dioxide partial pressure decreased in the treatment group and the control group.Compared with before treatment,the difference was statistically significant(P<0.05).The treatment group was more obvious than the control group(P<0.05).Conclusion:Dachengqi Decoction is effective in the treatment of pyemia and abdominal compartment syndrome.Its pharmacological effects may be related to the promotion of ant

关 键 词：大承气汤 脓毒症 腹腔间隔室综合征 抑炎因子 

分 类 号：R259[医药卫生—中西医结合]