脓毒症（sepsis）是创伤、烧伤、休克、感染等临床急危重病患者的严重并发症之一,也是诱发脓毒性休克、多器官功能障碍综合征（multiple organ dysfunction syndrome,MODS）的重要原因。胃肠道是人体最大的细菌及毒素库,胃肠道黏膜是抵...脓毒症（sepsis）是创伤、烧伤、休克、感染等临床急危重病患者的严重并发症之一,也是诱发脓毒性休克、多器官功能障碍综合征（multiple organ dysfunction syndrome,MODS）的重要原因。胃肠道是人体最大的细菌及毒素库,胃肠道黏膜是抵御细菌入侵的重要屏障且极易受损伤。危重病患者由于缺氧、感染、应激等各种刺激使胃肠道屏障改变、胃肠道免疫功能抑制、肠道内细菌和毒素移位,参与MODS的发病,故胃肠道被认为是危重病应激的“中心器官”和MODS的“启动器”。关于肠源性脓毒症的研究方兴未艾,本文就其机制和防治的研究进展作一综述。展开更多
Objective：To investigate the effect of dexamethasone（Dx） combined with modified Dachengqi Decoction（大承气汤,DCQD）,a Chinese herbal decoction for purgation,on patients with severe acute pancreatitis（SAP） accomp...Objective：To investigate the effect of dexamethasone（Dx） combined with modified Dachengqi Decoction（大承气汤,DCQD）,a Chinese herbal decoction for purgation,on patients with severe acute pancreatitis（SAP） accompanied with systematic inflammatory response syndrome（SIRS）.Methods：A total of 81 patients diagnosed as SAP were randomly assigned to a control group or treatment group according to a random number table generated from an SPSS software.The patients in the control group（38 cases） received standard treatment and Chinese herbal decoction for purgation;those in the treatment group（43 cases） received additional 1 mg/（kg·d） dexamethasone（Dx） treatment for three days based on the above treatment.The mortality rate,acute respiratory distress syndrome（ARDS）,renal failure,hemorrhage,sepsis,pancreatic pseudocyst, pancreatic abscess,operability,and days of hospitalization were compared between the two groups.Results： Three patients in the control group and eight patients in the treatment group dropped out from the study with a drop-out rate of 7.8%and 18.6%,respectively,and no statistics difference was shown between the two groups （P0.05）.Dx treatment significantly reduced ARDS rate and shortened the length of hospitalization compared to those in the control group（7/35,20.0%versus 15/35,42.9%,P=0.0394;32.5±13.2 days versus 40.2±17.5 days,P=0.0344）.Other parameters including the mortality rate were not significant different between the two groups.Conclusion：Dx combined with DCQD could decrease the risk of developing ARDS in SAP patients with SIRS and shorten their length of hospitalization.展开更多
目的:观察抗生素联合中药治疗对CLP所致大鼠SIRS的保护作用。方法:采用盲肠结扎穿孔术(Cecal ligation and punctured,CLP)制备大鼠SIRS模型,与空白及治疗对照组相比较。观察大鼠15min^48h的行为活动、精神状态、食欲、呼吸、大小便及...目的:观察抗生素联合中药治疗对CLP所致大鼠SIRS的保护作用。方法:采用盲肠结扎穿孔术(Cecal ligation and punctured,CLP)制备大鼠SIRS模型,与空白及治疗对照组相比较。观察大鼠15min^48h的行为活动、精神状态、食欲、呼吸、大小便及死亡率等一般情况;于造模后12h眶静脉取血测白细胞、红细胞、血小板计数及TNF-α浓度的变化。结果:治疗组与模型组大鼠均出现一般情况恶化;各治疗组死亡率均低于模型组,而中药+抗生素对照组降低最明显;模型组与空白对照组比较:WBC、TNF-α较高(P<0.01);各治疗组WBC、TNF-α均显著降低(P<0.05),其中中药+抗生素对照组又较其他治疗组降低更为显著。结论:解毒抗炎合剂联合泰能对CLP所致大鼠SIRS有一定的保护作用。其机制可能与抑制腹腔感染大鼠白细胞升高幅度、减轻炎症因子的释放、避免细胞因子水平的失控变化有关,从而降低大鼠死亡率。展开更多
文摘脓毒症（sepsis）是创伤、烧伤、休克、感染等临床急危重病患者的严重并发症之一,也是诱发脓毒性休克、多器官功能障碍综合征（multiple organ dysfunction syndrome,MODS）的重要原因。胃肠道是人体最大的细菌及毒素库,胃肠道黏膜是抵御细菌入侵的重要屏障且极易受损伤。危重病患者由于缺氧、感染、应激等各种刺激使胃肠道屏障改变、胃肠道免疫功能抑制、肠道内细菌和毒素移位,参与MODS的发病,故胃肠道被认为是危重病应激的“中心器官”和MODS的“启动器”。关于肠源性脓毒症的研究方兴未艾,本文就其机制和防治的研究进展作一综述。
基金Supported by the National NaturalScience Foundatioon of China (No.30400576,30801457)
文摘Objective：To investigate the effect of dexamethasone（Dx） combined with modified Dachengqi Decoction（大承气汤,DCQD）,a Chinese herbal decoction for purgation,on patients with severe acute pancreatitis（SAP） accompanied with systematic inflammatory response syndrome（SIRS）.Methods：A total of 81 patients diagnosed as SAP were randomly assigned to a control group or treatment group according to a random number table generated from an SPSS software.The patients in the control group（38 cases） received standard treatment and Chinese herbal decoction for purgation;those in the treatment group（43 cases） received additional 1 mg/（kg·d） dexamethasone（Dx） treatment for three days based on the above treatment.The mortality rate,acute respiratory distress syndrome（ARDS）,renal failure,hemorrhage,sepsis,pancreatic pseudocyst, pancreatic abscess,operability,and days of hospitalization were compared between the two groups.Results： Three patients in the control group and eight patients in the treatment group dropped out from the study with a drop-out rate of 7.8%and 18.6%,respectively,and no statistics difference was shown between the two groups （P0.05）.Dx treatment significantly reduced ARDS rate and shortened the length of hospitalization compared to those in the control group（7/35,20.0%versus 15/35,42.9%,P=0.0394;32.5±13.2 days versus 40.2±17.5 days,P=0.0344）.Other parameters including the mortality rate were not significant different between the two groups.Conclusion：Dx combined with DCQD could decrease the risk of developing ARDS in SAP patients with SIRS and shorten their length of hospitalization.
文摘目的:观察抗生素联合中药治疗对CLP所致大鼠SIRS的保护作用。方法:采用盲肠结扎穿孔术(Cecal ligation and punctured,CLP)制备大鼠SIRS模型,与空白及治疗对照组相比较。观察大鼠15min^48h的行为活动、精神状态、食欲、呼吸、大小便及死亡率等一般情况;于造模后12h眶静脉取血测白细胞、红细胞、血小板计数及TNF-α浓度的变化。结果:治疗组与模型组大鼠均出现一般情况恶化;各治疗组死亡率均低于模型组,而中药+抗生素对照组降低最明显;模型组与空白对照组比较:WBC、TNF-α较高(P<0.01);各治疗组WBC、TNF-α均显著降低(P<0.05),其中中药+抗生素对照组又较其他治疗组降低更为显著。结论:解毒抗炎合剂联合泰能对CLP所致大鼠SIRS有一定的保护作用。其机制可能与抑制腹腔感染大鼠白细胞升高幅度、减轻炎症因子的释放、避免细胞因子水平的失控变化有关,从而降低大鼠死亡率。
