加味桃核承气汤治疗脓毒症胃肠功能障碍的临床观察  

Clinical Effect of Jiawei Taohe Chengqi Decoction on Sepsis Gastrointestinal Dysfunction

作　　者：陈羽 申建国[1] 王健[1] Chen Yu;Shen Jianguo;Wang Jian(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,Cangzhou Hebei 061000)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061000

出　　处：《世界中西医结合杂志》2021年第6期1073-1078,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020471)。

摘　　要：目的探讨加味桃核承气汤治疗脓毒症胃肠功能障碍的临床疗效。方法选取2018年6月—2019年6月期间,河北省沧州中西医结合医院重症医学科和急诊ICU收治的脓毒症胃肠功能障碍患者120例作为研究对象,按随机数字表法分为对照组60例和治疗组60例。对照组采用常规西医治疗,治疗组在对照组基础上加用加味桃核承气汤治疗。两组患者均连续治疗1周后对两组临床疗效、炎症指标[C反应蛋白(C reactive proteins,CRP)、降钙素原(procalcitonin,PCT)、淀粉样蛋白A(serum amyloid A,SAA)、白细胞介素-6(Interleukin-6,IL-6)]、胃肠功能指标[血清胃泌素-17(Gastrin-17,G-17)、胃蛋白酶原(pepsinogen,PG)]、腹内压、病情严重程度[采用急性生理和慢性健康量表(Acute Physiology And Chronic Health Evaluation,APACHEⅡ)及序贯器官功能衰竭量表(Sequential Organ Failure Assessment,SOFA)进行评估]及胃肠功能障碍评分进行分析比较。结果治疗后治疗组临床总有效率为96.67%(58/60),对照组临床总有效率为76.67%(46/60),两组比较,差异有统计学意义(P<0.05)。治疗7 d后两组患者肠鸣音、腹围及腹内压指标均优于治疗前,差异有统计学意义(P<0.05);且治疗组治疗7 d后肠鸣音、腹围及腹内压指标优于对照组,两组比较,差异有统计学意义(P<0.05)。治疗7 d后治疗组患者肠道功能0分、1分占比与对照组比较明显升高,2分、3分占比与对照组比较明显降低,两组比较,差异有统计学意义(P<0.05)。治疗3 d后治疗组患者SOFA及APACHEⅡ评分与治疗前比较明显降低,差异有统计学意义(P<0.05);治疗7 d后两组患者SOFA及APACHEⅡ评分与治疗前、治疗3 d后比较明显降低,差异有统计学意义(P<0.05);且治疗组治疗3 d、7 d后SOFA及APACHEⅡ评分均明显低于对照组同期水平,两组比较,差异有统计学意义(P<0.05)。治疗3 d后治疗组患者炎症指标CRP、IL-6、PCT及SAA水平与治疗前比较明显降低,差�Objective To explore the clinical efficacy of Jiawei Taohe Chengqi Decoction in the treatment of septic gastrointestinal dysfunction.Methods From June 2018 to June 2019,120 patients with sepsis and gastrointestinal dysfunction admitted to the Department of Critical Care Medicine and Emergency ICU of Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were selected as the research objects.They were divided into controls according to the random number table method.60 cases in the group and 60 cases in the treatment group.The control group was treated with conventional western medicine,and the treatment group was treated with Jiawei Taohe Chengqi Decoction on the basis of the control group.The two groups of patients were treated for 1 week on the clinical efficacy and inflammatory indicators of the two groups[C reactive proteins(CRP),procalcitonin(PCT),and amyloid A(SAA),Interleukin-6(IL-6)],gastrointestinal function indexes[serum gastrin-17(G-17),pepsinogen(PG)],intra-abdominal Pressure,severity of illness[using Acute Physiology And Chronic Health Evaluation(APACHE)and Sequential Organ Failure Assessment(SOFA)for assessment]and gastrointestinal dysfunction score were analyzed and compared.Results After treatment,the total clinical effective rate of the treatment group was 96.67%(58/60),and the total clinical effective rate of the control group was 76.67%(46/60).The difference between the two groups was statistically significant(P<0.05).After 7 days of treatment,the bowel sounds,abdominal circumference and intra-abdominal pressure indexes of the two groups of patients were better than those before treatment,and the difference was statistically significant(P<0.05);and the treatment group was treated for 7 days after bowel sounds,abdominal circumference and abdominal pressure.The internal pressure index was better than the control group,and the difference between the two groups was statistically significant(P<0.05).After 7 days of treatment,the proportions of intestinal function

关 键 词：加味桃核承气汤 脓毒症 胃肠功能障碍 

分 类 号：R631[医药卫生—外科学]