健脾清肠汤对脓毒症腹泻患者肠道功能、炎症因子及乳酸的影响  

Effects of Jianpi Qingchang Decoction on Intestinal Function, inflammatory factorsand Lactic Acid in Patients with Septic Diarrhea

作　　者：林俊儒[1] 游荣荣 华云玮 LIN Junru;YOU Rongrong;HUA Yunwei(Department of Emergency Medicine,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of Internal Medicine,Yuyuan Street Community Health Service Center,Huangpu District,Shanghai 200010,China;Department of Gastroenterology,Shanghai Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China)

机构地区：[1]上海中医药大学附属龙华医院急诊内科,上海200032 [2]黄浦区豫园街道社区卫生服务中心内科,上海200010 [3]上海中医药大学附属上海市中西医结合医院消化内科,上海200082

出　　处：《中医药学报》2024年第2期53-57,共5页Acta Chinese Medicine and Pharmacology

基　　金：上海中医药大学预算内项目(2021LK064)。

摘　　要：目的:本研究通过采用健脾清肠汤治疗脓毒症腹泻患者,评估健脾清肠汤对肠道功能及WBC、CRP、PCT、IL-6、IL-1β和乳酸水平的影响,进而明确健脾清肠汤治疗脓毒症腹泻的机制。方法:选取2021年4月—2023年3月上海中医药大学附属龙华医院确诊并收治的脓毒症伴腹泻患者93例,采用随机数字表法分为两组,观察组48例和对照组45例。两组患者均给予液体复苏及抗感染治疗,在此基础上观察组加用健脾清肠汤治疗,对照组加用酪酸梭菌活菌胶囊治疗。针对两组患者的临床疗效、大便性状及炎症指标、肠道功能以及安全性进行评价。结果:经过10 d治疗后,观察组症状量化积分高于对照组(P<0.05);治疗前,SOFA评分、Bristol评分两组间对比无明显差异(P>0.05);治疗后,与对照组相比,观察组SOFA评分、Bristol评分降低,差异有统计学差异(P<0.05);治疗前,WBC、CRP、PCT、IL-6、IL-1β、乳酸两组间对比无明显差异(P>0.05);治疗后,与对照组相比,观察组WBC、CRP、PCT、IL-6、IL-1β、乳酸水平降低,差异有统计学差异(P<0.05);两组患者治疗期间均未出现任何严重不良反应,安全等级较高。结论:健脾清肠汤可显著改善脓毒症患者的肠道功能,降低炎症因子的表达水平,具有较高的应用价值。Objective:In this study,septic diarrhea was treated by Jianpi Qingchang decoction(JQD),the effects of JQD on intestinal function,WBC,CRP,PCT,IL-6,IL-1βand lactic acid levels were evaluated,so as to clarify the mechanism of JQD in the treatment of septic diarrhea.Methods:A total of 93 patients with sepsis and diarrhea admitted to Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from April 2021 to March 2023 were divided into two groups by random number table,with 48 patients in the observation group and 45 in the control group.Both groups of patients were given liquid and anti infection treatment.Additionally,observation group was treated with JQD,while the control group was treated with clostridium butyricum viable capsule.The clinical efficacy,stool characteristics,inflammatory indicators,intestinal function and safety of the two groups were evaluated.Results:After 10 days of treatment,in terms of clinical efficacy,the symptom quantification score of the observation group was higher than that of the control group(P<0.05).Before treatment,there was no significant difference in SOFA score and Bristol score between the two groups(P>0.05);after treatment,compared with the control group,the SOFA score and Bristol score of the observation group decreased,and there was a statistical difference(P<0.05).Before treatment,there were no significant differences in WBC,CRP,PCT,IL-6,IL-1βand lactic acid between the two groups(P>0.05);after treatment,compared with the control group,the levels of WBC,CRP,PCT,IL-6,IL-1β,and lactic acid in the observation group were statistically lower,with statistical difference(P<0.05).No serious adverse reactions occurred in the two groups during the treatment,and the safety level was high.Conclusion:Jianpi Qingchang decoction can significantly improve the intestinal function and reduce the expression levels of inflammatory factors in patients with sepsis,and has high application value.

关 键 词：健脾清肠汤 脓毒症 腹泻 肠道功能 炎症因子 

分 类 号：R285.6[医药卫生—中药学]