自拟大黄汤鼻饲联合保留灌肠对重症急性有机磷中毒患者心肌酶谱及排便次数的影响  

Effects of nasal feeding of self-made Dahuang decoction combined with retention enema on myocardial enzymes and defecation frequency in patients with severe acute organophosphate poisoning

作　　者：张清学 赵曙光[1] 杨广训 Zhang Qing-xue;Zhao Shu-guang;Yang Guang-xun(Department of emergency medicine,Taihe County People's Hospital,Fuyang,Anhui 236600,China;Department of Integrated Chinese and Western medicine,Taihe County People's Hospital,Fuyang,Anhui 236600,China)

机构地区：[1]太和县人民医院急诊医学科,安徽太和236600 [2]太和县人民医院中西医结合科,安徽太和236600

出　　处：《四川中医》2020年第6期89-92,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探究自拟大黄汤鼻饲联合保留灌肠治疗重症急性有机磷中毒对患者心肌酶谱及排便次数的影响。方法:选取2017年1月~2019年12月于我院接受治疗的102例重症急性有机磷中毒患者为受试对象,使用随机数字表法分为研究组与对照组,每组患者各51例。对照组予以常规治疗,研究组在对照组基础上予以自拟大黄汤鼻饲联合保留灌肠治疗。比较两组患者治疗后死亡率、死亡前平均生存时间差异,比较两组患者治疗前及治疗3d后心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]、血清炎性因子[白介素-6(IL-6)、血清C反应蛋白(CRP)]水平变化差异,比较两组患者治疗情况(用药后首次排便时间、日排便次数、达到阿托品化时间)、并发症发生差异。结果:治疗后,两组患者死亡率差异不显著(P>0.05),死亡前平均生存时间长于对照组(P<0.05);治疗3d后,两组患者CK、CK-MB、IL-6、CRP均较治疗前下降,且研究组低于同期对照组(P均<0.05);治疗后,研究组患者用药后首次排便时间、达到阿托品化时间均低于对照组(P均<0.05),而日排便次数多于对照组(P<0.05);治疗后,两组患者并发症发生差异不显著(P均>0.05)。结论:自拟大黄汤鼻饲联合保留灌肠对重症急性有机磷中毒患者心肌酶谱恢复正常,可减轻患者炎性反应,促进患者排便,减少患者并发症发生。Objective To investigate the effects of nasal feeding of self-made Dahuang decoction combined withretention enema on myocardial enzymes and defecation frequency in patients with severe acute organophosphate poisoning.Methods A total of 102 patients with severe acute organophosphorus poisoning who were treated in our hospital from January 2017 to December 2019 were selected as the study subjects.They were divided into study group and control group according to the random number table method,with 51 cases in each group.Control group was given conventional treatment while study group was givennasal feeding of self-made Dahuang decoction combined with retention enema on the basis of control group.The differences in mortality rate after treatment and mean survival time before death were compared between the two groups,and the myocardial enzymes [creatine kinase(CK),creatine kinase isozyme(CK-MB)] and serum inflammatory factors [interleukin-6(IL-6),serum c-reactive protein(CRP)] were compared between the two groups before treatment and after 3 d of treatment,and the treatment status(first defecation time after medicine,daily defecation frequency,time of reaching atropinization) and occurrence of complications were compared between the two groups.Results After treatment,there was no significant difference in the mortality rate between the two groups(P>0.05),and the mean survival time before death was longer than that in control group(P<0.05).After 3 d of treatment,the levels of CK,CK-MB,IL-6 and CRP in the two groups were increased compared with those before treatment,and the levels in study group were lower than those in control group at the same period(P<0.05).After treatment,thefirst defecation time after medicine and time of reaching atropinization in study group were lower than those in control group(P<0.05),and the daily defecation frequency was more than that in control group(P<0.05).After treatment,there were no significant differences in the occurrence of complications between the two groups(allP>0.05).Conclusi

关 键 词：自拟大黄汤 灌肠 重症 急性有机磷中毒 心肌辅酶 

分 类 号：R595.4[医药卫生—内科学]