大承气汤联合穴位超声导入疗法治疗危重症腹内高压临床研究  

Clinical Study on Dachengqi Decoction Combined with Point Ultrasound Introduction Therapy for Severe Intra-Abdominal Hypertension

作　　者：温正旺 郑建 郑玲玲 陶真 WEN Zhengwang;ZHENG Jian;ZHENG Lingling;TAO Zhen(Department of Critical Care Medicine,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou Zhejiang325000,China)

机构地区：[1]温州市中西医结合医院重症医学科,浙江温州325000

出　　处：《新中医》2024年第4期146-150,共5页New Chinese Medicine

基　　金：温州市科技局课题(Y20210560)。

摘　　要：目的:观察大承气汤联合穴位超声导入疗法治疗危重症腹内高压的临床疗效。方法:选取50例危重症腹内高压患者作为研究对象,按照随机数字表法分为对照组和观察组各25例。在常规西医治疗的基础上,对照组加用大承气汤治疗,观察组加用大承气汤联合穴位超声导入疗法治疗。观察2组康复指标、急性生理及慢性健康状况评分(APCHEⅡ)、急性胃肠损伤分级(AGI)、营养风险筛查量表评分、中医证候评分以及不良反应发生率。结果:治疗后,观察组腹内压、排便频率、腹围均低于对照组(P<0.05),ICU住院时间及机械通气时间均短于对照组(P<0.05)。治疗后3、5、7 d,2组APCHEⅡ评分均较治疗后1 d降低(P<0.05),并呈下降趋势(P<0.05);且观察组APCHEⅡ评分在同时间点均低于对照组(P<0.05)。治疗后,2组AGI分级均较治疗前改善(P<0.05),观察组AGI分级优于对照组(P<0.05)。治疗后3、5、7 d,2组营养风险筛查量表评分均较治疗后1 d降低(P<0.05),并呈下降趋势(P<0.05);且观察组营养风险筛查量表评分在同时间点均低于对照组(P<0.05)。治疗后,2组腹部胀满、腹痛、发热、呕吐、口干口臭、大便干结等中医证候评分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗后,观察组不良反应发生率为8.00%,对照组为12.00%,2组比较,差异无统计学意义(P>0.05)。结论:大承气汤联合穴位超声导入疗法治疗危重症腹内高压能够促进患者病情康复,有效改善急性胃肠损伤,提高患者健康及营养状况,且安全性良好。Objective:To observe the clinical effect of Dachengqi Decoction combined with point ultrasound introduction therapy on severe intra-abdominal hypertension.Methods:A total of 50 cases of patients with severe intra-abdominal hypertension were selected as the study objects and divided into the control group and the observation group according to the random number table method,with 25 cases in each group.Based on routine western medicine treatment,the control group was additionally treated with Dachengqi Decoction,and the observation group was additionally treated with Dachengqi Decoction combined with point ultrasound introduction therapy.Rehabilitation indexes,Acute Physiology and Chronic Health Evaluation Ⅱ(APCHE Ⅱ)scores,Acute Gastrointestinal Injury(AGl)grading,nutritional risk screening,traditional Chinese medicine(TCM)syndrome scores and the incidence of adverse reactions in the two groups were observed.Results:After treatment,intra-abdominal pressure,defecation frequency and abdominal circumference in the observation group were lower than those in the control group(P<0.05),the length of ICU stay and the duration of mechanical ventilation were shorter than those in the control group(P<0.05).On day 3,5 and 7 after treatment,the APCHE Ⅱ scores in the two groups were decreased when compared with those on day 1 after treatment(P<0.05)and showed a decreasing trend(P<0.05);the APCHE Ⅱ scores in the observation group were lower than those in the control group at the same time point(P<0.05).After treatment,the AGl grading in the two group were improved when compared with those before treatment(P<0.05),and the AGl grading in the observation group was better than that in the control group(P<0.05).On day 3,5 and 7 after treatment,the scores of nutritional risk screening in the two groups were decreased when compared with those on day 1 after treatment(P<0.05)and showed a decreasing trend(P<0.05);the scores of nutritional risk screening in the observation group were lower than those in the control group at the sam

关 键 词：危重症腹内高压 大承气汤 穴位超声导入疗法 急性生理及慢性健康状况评分 急性胃肠损伤分级 

分 类 号：R278[医药卫生—中医学]