大承气汤对多器官功能障碍综合征防治作用的临床研究  

Effective study of Dachengqi decoction(大承气汤) on multiple organ dysfunction syndrome

作　　者：崔克亮[1] 曹书华[1] 王今达[1] 

机构地区：[1]天津市第一中心医院ICU,天津300192

出　　处：《中国中西医结合急救杂志》2003年第1期12-15,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：天津市科委课题科研基金资助项目 (983 113 411)

摘　　要：目的 :比较采用西医常规治疗加安慰剂和中西医结合方法对多器官功能障碍综合征 (MODS)的防治效果。方法 :选择 1999年 6月— 2 0 0 0年 9月收入我院 ICU的 5 1例全身炎症反应综合征 (SIRS)患者 ,随机分为治疗组 (2 5例 ,采用西医常规治疗加大承气汤 )和对照组 (2 6例 ,采用西医常规治疗加安慰剂 ) ,进行前瞻性安慰剂对照研究。观察患者的临床表现及预后 ,监测血内毒素、肿瘤坏死因子 α(TNFα)、白介素 1β(IL 1β)、IL 4、IL 6、IL 10和人白细胞抗原 DR(HL A DR)等 7项指标 ,判断大承气汤的作用效果。结果 :大承气汤治疗组患者的体内炎性介质水平普遍改善 ,治疗组患者的 MODS病死率显著降低 (2 8.5 7%比 70 .5 9% ,P=0 .0 32 )。结论 :大承气汤结合西医治疗能够调节 SIRS患者免疫功能 ,改善 MODS病情。Objective:To estimate the effect of traditional Chinese and western medicine on multiple organ dysfunction syndrome (MODS).Methods:We conducted a prospective casecontrol study with 51 systemic inflammatory response syndrome(SIRS) patients in ICU during June 1999 to September 2000.Twentyfive patients in treatment group were treated with western medicine combined Dachengqi decoction,26 patients in control group were treated with western medicine alone.Patients' clinical situation and outcome were observed ,meanwhile the blood levels of endotoxin,tumor necrosis factorα (TNFα),interleukin1β ( IL1β ), IL4 , IL6 ,IL10 and human leukocyte antigen(HLA)DR(HLADR) were monitored. Results: The inflammatory mediators of treatment group improved significantly,and mortality of treatment group significant decreased compared to control group (28 57% vs 70 59%, P =0 032).Conclusion:Dachengqi decoction combined with western medicine can regulate patient's immune function,improve the outcome of MODS.

关 键 词：多器官功能障碍综合征 全身炎症反应综合征 大承气汤 内毒素 细胞因子 炎性介质 MODS 中西医结合疗法 

分 类 号：R285.5[医药卫生—中药学]