摘要
目的观察调胃承气汤对脓毒症胃肠损伤患者胃肠功能及免疫状态的影响。方法选取2017年10月-2019年5月于广州中医药大学第一附属医院重症医学科收治的脓毒症胃肠损伤患者56例,按就诊顺序进行编号,采用奇偶数法将其随机分为对照组和治疗组,各28例。对照组予西医常规治疗,治疗组在对照组的基础上加用调胃承气汤,1剂/次,2次/d,口服或鼻饲,7 d为1个疗程。观察两组的中医证候疗效、肠鸣音、腹围、腹内压、病情危重程度评分、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、人白细胞DR抗原(HLA-DR)、淋巴细胞总数、CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、自然杀伤(NK)细胞及并发症发生情况。结果治疗组的总有效率高于对照组(P<0.05)。治疗后,两组的肠鸣音多于治疗前,腹围短于治疗前,腹内压低于治疗前,且治疗组的肠鸣音多于对照组,腹围短于对照组,腹内压低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的序贯器官衰竭估计评分及急性生理与慢性健康状况Ⅱ评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后的WBC、CRP及PCT水平均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组HLA-DR、淋巴细胞总数、CD3^+、CD4^+、CD8^+、CD4^+/CD8^+及NK细胞均高于治疗前,且治疗组高于对照组,差异有统计学意义(P<0.05)。两组均未见明显毒副作用。结论调胃承气汤结合西医治疗能有效改善脓毒症胃肠损伤患者的胃肠功能,良性调节患者的免疫状态,疗效优于单纯西医治疗,且安全无毒副作用。
Objective To observe the effects of Tiaowei Chengqi Decoction on gastrointestinal function and immune status in patients with gastrointestinal injury caused by sepsis.Methods From October 2017 to May 2019,56 patients with gastrointestinal injury caused by sepsis admitted to Department of Critical Care Medicine in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were selected.They were numbered according to the order of treatment and divided into control group and treatment group by using odd even number method,with 28 cases in each group.Control group was given conventional Western medicine treatment,while treatment group was given Tiaowei Chengqi Decoction,once one dose,twice a day,oral or nasal feeding,seven days as a course of treatment.Traditional Chinese medicine syndrome efficacy,bowel sound abdominal circumference,intra-abdominal pressure,scores of disease severity,white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),human leukocyte antigen-DR(HLA-DR),total lymphocyte count,CD3+,CD4+,CD8+,CD4+/CD8+,natural killer(NK)cells and complications were observed between two groups.Results Total effective rate of treatment group was higher than that of control group(P<0.05).After treatment,the bowel sound of two groups was more than that before treatment,the abdominal circumference was shorter than that before treatment,and the intra-abdominal pressure was lower than that before treatment,and the bowel sound of treatment group was more than that of control group,the abdominal circumference was shorter than that of control group,and the intra-abdominal pressure was lower than that of control group,the differences were statistically significant(P<0.05).After treatment,the sequential organ failure assessment score and acute physiology and chronic health statusⅡscore of two groups were lower than those before treatment,and treatment group was lower than control group,the differences were statistically significant(P<0.05).The levels of WBC,CRP and PCT in two groups after treat
作者
张先进
刘敏
林新锋
温敏勇
吴思慧
赵馥
赵锋利
ZHANG Xianjin;LIU Min;LIN Xinfeng;WEN Minyong;WU Sihui;ZHAO Fu;ZHAO Fengli(Department of Critical Care Medicine,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510405,China)
出处
《中国医药导报》
CAS
2020年第25期119-124,共6页
China Medical Herald
基金
广东省科学技术厅科技计划项目(2016ZC0101)。
关键词
调胃承气汤
脓毒症
急性胃肠损伤
细胞免疫
Tiaowei Chengqi Decoction
Sepsis
Acute gastrointestinal injury
Cellular immunity
