调胃承气汤对重症患者胃肠功能障碍的治疗作用研究  

Therapeutic Effect of Tiaowei Chengqi Decoction on Gastrointestinal Dysfunction in Critical Ill Patients

作　　者：曹蕊 林新锋[1] 杨海淦 陈静 CAO Rui;LIN Xin-Feng;YANG Hai-Gan;CHEN Jing(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2020年第3期418-421,共4页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察调胃承气汤对重症患者胃肠功能障碍的治疗作用。【方法】将50例符合纳入标准的有胃肠功能障碍的重症(胃肠燥热证)患者随机分成治疗组和对照组,每组各25例。对照组给予常规西医治疗,治疗组在常规西医治疗基础上配合调胃承气汤加减鼻饲治疗,治疗周期为5 d。观察2组患者治疗前后腹内压、氧合指数及急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分的变化情况,并比较2组治疗后排便情况。【结果】(1)治疗后,2组患者的腹内压、氧合指数及APACHEⅡ评分均较治疗前明显改善(P<0.05),且治疗组的改善作用均明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,治疗组的首次排便时间较对照组明显缩短,每日排便次数较对照组明显增多,差异均有统计学意义(P<0.05)。【结论】调胃承气汤能有效改善重症患者的胃肠功能障碍及预后。Objective To observe the clinical effect of Tiaowei Chengqi Decoction on gastrointestinal dysfunction in critical ill patients. Methods Fifty critical ill patients with stomach-intestine dry heat syndrome were divided into treatment group and control group,25 cases in each group. The control group received routine western medicine treatment,and the treatment group was treated with nasogastric feeding of Tiaowei Chengqi Decoction combined with routine western medicine treatment. The treatment period for the two groups covered 5 days. Before and after treatment,the changes of intra-abdominal pressure,oxygenation index and the scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in the two groups were observed. And after treatment,the defecation was compared between the two groups. Results(1)After treatment,the intra-abdominal pressure,oxygenation index and APACHE Ⅱ scores in the two groups were much improved in comparison with those before treatment(P<0.05),and the improvement in the treatment group was superior to that in the control group,the difference being statistically significant(P < 0.05).(2)After treatment,time for the first defecation was obviously shortened and the frequency of daily defecation was obviously increased in the treatment group as compared with those in the control group,and the difference was statistically significant(P < 0.05). Conclusion Tiaowei Chengqi Decoction can effectively improve the gastrointestinal dysfunction and prognosis of critical ill patients, being worth of expanding the clinical application.

关 键 词：调胃承气汤 胃肠功能障碍 胃肠燥热证 腹内压 氧合指数 APACHEⅡ评分 

分 类 号：R278[医药卫生—中医学]