摘要
目的观察调气通腑健脾方对脓毒症胃肠功能障碍患者外周血细胞因子、血内毒素水平及肠道机械屏障修复的影响。方法选择脓毒症胃肠功能障碍患者98例,按随机数字表法分为两组各49例,对照组给予常规基础治疗,治疗组给予基础治疗联合调气通腑健脾方治疗,比较两组患者治疗前后血白细胞计数(WBC)、白细胞介素-17(IL-17)、可溶性髓系细胞触发受体-1(sTREM-1)、生长素释放肽(Ghrelin)、胃泌素-17(G-17)、脂肪酸结合蛋白(I-FABP)、二胺氧化酶(DAO)、乳酸(Lac)、内毒素、SAA水平,与急性生理与慢性健康状况(APACHEⅡ)评分及中医证候积分,观察两组用药安全性及临床疗效。结果治疗后,治疗组WBC、IL-17、SAA、sTREM-1、DAO、I-FABP、内毒素、Lac水平低于对照组(P<0.05),治疗组患者G-17、Ghrelin水平高于对照组(P<0.05),治疗组患者APACHEⅡ、中医证候积分低于对照组(P<0.05),治疗组总有效率为95.92%,高于对照组的81.63%(P<0.05),两组均无明显不良反应。结论调气通腑健脾方对脓毒症胃肠功能障碍患者,可减少外周血细胞因子水平,抑制患者炎症,降低血内毒素水平,促进肠道机械屏障修复,提升患者胃肠动力,改善患者临床症状。
Objective:To observe the effect of Tiaoqi Tongfu Jianpi Decoction on peripheral blood cytokines,blood endotoxin levels and intestinal mechanical barrier repair in patients with sepsis gastrointestinal dysfunction.Methods:A total of 98 patients with sepsis and gastrointestinal dysfunction were selected and grouped according to the random number table method,49 patients in each group.The control group was given basic treatment,and the treatment group was given basic treatment combined with Tiaoqi Tongfu Jianpi Decoction.The blood white blood cell(WBC)count,interleukin 17(IL-17),soluble triggering receptor expresses on myeloid cells-1(sTREM-1),ghrelin,gastrin-17(G-17),fatty acid binding protein(I-FABP),diamine oxidation Enzyme(DAO),lactic acid(Lac),endotoxin levels,SAA,acute physiology and chronic health status score(APACHEⅡ)and TCM syndrome evaluation were compared;the safety and clinical efficacy of the two groups were observed.Results:The levels of WBC,IL-17,SAA and sTREM-1 in the treatment group were lower than those in the control group(P<0.05).The levels of DAO,I-FABP,endotoxin and Lac in the treatment group were lower than those in the control group(P<0.05).The levels of G-17 and ghrelin in the treatment group were higher than those in the control group(P<0.05),the APACHEⅡ and TCM syndrome scores in the treatment group were lower than those in the control group(P<0.05),and the total effective rate in the treatment group was higher than that in the control group(95.92%vs.81.63%,P<0.05);no obvious adverse reactions were observed in both groups.Conclusion:Tiaoqi Tongfu Jianpi Decoction can reduce the level of peripheral blood cytokines,inhibit the inflammation of patients with sepsis gastrointestinal dysfunction,reduce the level of blood endotoxin,promote the repair of the intestinal mechanical barrier,improve the gastrointestinal motility,and improve the clinical symptoms.
作者
刘超
林孟柯
孙冉冉
Liu Chao;Lin Mengke;Sun Ranran(Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital,Beijing 101300,China)
出处
《中国中医急症》
2023年第3期452-455,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
北京市卫生健康发展科研培育计划(PZ2021028)。
关键词
脓毒症
胃肠功能障碍
调气通腑健脾方
外周血细胞因子
内毒素
肠道机械屏障修复
Sepsis
Gastrointestinal dysfunction
Tiaoqi Tongfu Jianpi Decoction
Peripheral blood cytokines
Endotoxin
Intestinal mechanical barrier repair
