自拟灌肠方辅助治疗对脓毒症胃肠功能障碍患者胃肠功能及炎症因子的影响  

Effect of Self-made Enema Decoction on Gastrointestinal Function and Inflammatory Factors in Patients with Sepsis with Gastrointestinal Dysfunction

作　　者：胡乃强[1] 唐秋莲 卢同兴 陈玉芳 欧日英 余梅平 黄盛海 何雪明 Hu Naiqiang;Tang Qiulian;Lu Tongxing;Chen Yufang;Ou Riying;Yu Meiping;Huang Shenghai;He Xueming(International Zhuang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,Guangxi,Nanning 530021,China)

机构地区：[1]广西中医药大学附属国际壮医医院,广西南宁530021

出　　处：《中国中医急症》2024年第1期53-56,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广西壮族自治区中医药局自筹经费科研课题(GZZC2019004);2022年广西中医药大学附属国际壮医医院“青苗工程”培育项目“青年英才”(20220001)。

摘　　要：目的 观察自拟灌肠方灌肠辅助治疗对脓毒症胃肠功能障碍患者的临床疗效。方法 选取脓毒症胃肠功能障碍患者100例,随机分为两组各50例,均给予西医常规治疗。对照组加用0.9%氯化钠注射液灌肠,治疗组加用自拟灌肠方灌肠,疗程均为7 d。结果 治疗组总有效率明显高于对照组(P<0.05);治疗后,两组胃肠动力指标血清胃动素(MTL)均较前升高、活性肠肽(VIP)均较前降低(P<0.05);治疗后两组患者急性生理与慢性健康量表(APACHE Ⅱ)评分、肠黏膜屏障功能指标、炎性指标均较治疗前降低,治疗组治疗后各指标较对照组降低(P<0.05);治疗后,两组中医症状积分、胃肠功能障碍积分有所改善,且治疗组指标较对照组降低(P<0.05);治疗组多器官功能障碍综合征(MODS)发生率(18.00%)低于对照组(42.00%)(P<0.05);两组28 d病死率相当(P>0.05)。结论 运用自拟灌肠方辅助治疗方案,可改善脓毒症胃肠功能障碍患者胃肠症状,恢复胃肠功能,降低炎症因子水平,降低MODS发生率,改善患者预后。Objective:To explore the clinical efficacy of self-made Enema Decoction in the treatment of sepsis with gastrointestinal dysfunction.Methods:A total of 100 patients with sepsis and gastrointestinal dysfunction who were selected and randomly divided into two groups,50 cases in each group.All patients were given conventional treatment with western medicine.The control group was treated with 0.9%sodium chloride injection enema,and the treatment group was treated with self-made Enema Decoction.The course of treatment was 7 days.Results:The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05),and after treatment,the gastrointestinal motility index MTL were higher and VIP were lower in both groups compared with before treatment(P<0.05);after treatment,the APACHEⅡscore,intestinal mucosal barrier function index,and inflammatory indexes of the two groups were lower than those before treatment,and the indexes in the treatment group were lower than those in the control group after treatment(P<0.05);after treatment,the TCM symptom score and gastrointestinal dysfunction score of the two groups were improved,and the treatment group was lower than that of the control group(P<0.05);the incidence of MODS in the treatment group 18.00%was lower than that in the control group 42.00%(P<0.05);the 28 day case fatality rate was comparable between the two groups(P>0.05).Conclusion:The application of self-made Enema Decoction as an adjuvant treatment can improve gastrointestinal symptoms,restore gastrointestinal function,reduce the level of inflammatory factors,reduce the incidence of MODS,and improve the prognosis of patients with sepsis with gastrointestinal dysfunction.

关 键 词：脓毒症 胃肠功能障碍 灌肠方 随机对照试验 

分 类 号：R631[医药卫生—外科学]