炎调方治疗脓毒症致急性胃肠损伤(腑实营热证)的临床研究  

Clinical Efficacy Observation of Yantiao Decoction for Acute Gastrointestinal Injury Caused by Sepsis

作　　者：金源源 施荣[1] 凌琪华[1] 方荣[1] 王倩[1] Jin Yuanyuan;Shi Rong;Ling Qihua;Fang Rong;Wang Qian(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《中国中医急症》2021年第9期1586-1589,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海申康医院发展中心临床科技创新项目(SHDC12017X23)。

摘　　要：目的观察炎调方对脓毒症致急性胃肠损伤(AGI)(腑实营热证)患者胃肠功能、炎症因子的影响。方法采用多中心随机对照研究将120例患者分为治疗组与对照组各60例。两组患者均予指南常规治疗,治疗组加用炎调方,对照组加用安慰剂,疗程7 d。观察两组中医临床疗效、胃肠功能指标、炎症指标及临床症状改善情况。结果治疗组总显效率为85.00%,高于对照组的48.33%(P <0.05);治疗3 d,治疗组胃泌素、胃动素水平高于对照组(P <0.05);治疗7 d,治疗组白细胞计数、C反应蛋白、降钙素原、D乳酸、肿瘤坏死因子-α、白细胞介素-8水平均低于对照组,而胃动素、胃泌素水平高于对照组(P <0.05);治疗7 d,治疗组中医证候总积分、序贯器官衰竭(SOFA)评分、腹内压、腹围低于对照组(P <0.05)。结论炎调方可恢复脓毒症致AGI(腑实营热证)患者的胃肠功能,减轻炎症反应,降低SOFA评分,缓解临床症状,提高中医临床疗效。Objective:To observe the efficacy of Yantiao Decoction on gastrointestinal function and inflammatory factors in patients with sepsis-induced acute gastrointestinal injury(Fushi Yingre Syndrome).Methods:A multicenter randomized controlled study was adopted,including 120 patients were divided into 60 patients in the treatment group and 60 patients in the control group.Both groups received guideline routine treatment.On this basis,the treatment group was additionally treated with Yantiao Decoction,while the control group was additionally treated with placebo;the course of treatment was 7 days.The excellent effective rate of TCM treatment,the serological indexes of gastrointestinal function,inflammatory factors and the improvement of clinical symptoms were observed.Results:The excellent effective rate of the treatment group was 85.00%,which was significantly better than 48.33%of the control group(P<0.05).On the third day of treatment,the levels of motilin and gastrin in the treatment group were higher than those in the control group(P<0.05).On the seventh day of treatment,the levels of WBC,CRP,PCT,D-lactic acid,TNF-α,IL-8 in the treatment group were lower than those in the control group,while the levels of GAS and MTL in the treatment group were higher than those in the control group(P<0.05).On the seventh day of treatment,the total score of TCM syndrome,SOFA score,intra-abdominal pressure and abdominal circumference in the treatment group were lower than those in the control group(P<0.05).Conclusion:Yantiao Decoction can promote the recovery of gastrointestinal function,reduce inflammatory response,decrease SOFA,alleviate clinical symptoms and improve TCM clinical efficacy of patients with sepsis-induced acute gastrointestinal injury(Fushi Yingre Syndrome).

关 键 词：脓毒症 急性胃肠损伤 炎调方 胃肠功能 炎症因子 

分 类 号：R631[医药卫生—外科学]