大承气汤化裁保留灌肠治疗脓毒症的临床疗效及对凝血功能的影响

发布时间：2018-02-10 18:38

本文关键词： 大承气汤化裁脓毒症保留灌肠凝血功能　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:采用大承气汤化裁保留灌肠,观察其治疗脓毒症(瘀毒内阻型)的临床疗效及对凝血功能的影响,为临床上中西医结合治疗脓毒症提供新的参考。方法:本研究采取随机对照原则,选取符合纳入标准的64例患者,试验组及对照组各32例。试验组应用大承气汤化裁保留灌肠结合西医治疗,对照组应用温水保留灌肠及西医治疗。患者在纳入时、第三天、第七天进行SOFA评分、APACHE-II评分及中医证候积分,记录其体温、呼吸频率等一般指标,并抽取外周动静脉血进行凝血四项(活化部分凝血激酶时间、血浆凝血酶时间、凝血酶原时间、纤维蛋白原)、D-二聚体、乳酸、血小板指标的检测。结果:试验组大承气汤化裁保留灌肠治疗后第三天、第七天,呼吸、凝血四项、D-二聚体、乳酸、血小板、APACHE-II评分、SOFA评分、中医证候积分的变化幅度与对照组相比较,差异具有统计学意义(P0.05)。且大承气汤化裁保留灌肠治疗后第七天与第三天检测指标水平相比改善较为显著。试验组治疗后第七天,体温的变化幅度与对照组相比较,差异具有统计学意义(P0.05)。结论:1.大承气汤化裁保留灌肠可以提高脓毒症(瘀毒内阻型)患者的临床疗效。2.大承气汤化裁保留灌肠可以有效降低脓毒症(瘀毒内阻型)患者凝血四项、D-二聚体和乳酸水平,升高血小板计数水平,改善患者的呼吸及体温情况。3.大承气汤化裁保留灌肠有效降低脓毒症(瘀毒内阻型)患者的APACHE-II评分、SOFA评分及中医证候积分。
[Abstract]:Objective: using Dachengqi Decoction retention enema, observe the treatment of sepsis (stasis resistance type) clinical efficacy and effect on blood coagulation function, provide a new reference for the clinical combination of Chinese medicine and Western medicine in the treatment of sepsis. Methods: This study adopts random control principle, selected 64 cases of inclusion. Standard patients, test group and control group with 32 cases in each group. The experimental group used Dachengqi Decoction retention enema combined with western medicine treatment, the control group used water enema and Western medicine treatment. Patients in third days, seventh days, SOFA score, APACHE-II score and TCM syndrome score, to record the temperature. Respiratory frequency index, and extraction of peripheral venous blood coagulation four (activated partial thromboplastin time, thrombin time, prothrombin time, fibrinogen), two D- dimer, lactic acid, blood platelet index detection. Results: the experimental group. Gas Decoction retention enema in the treatment of third days, seventh days after breathing, four items of blood coagulation, two D- dimer, lactic acid, platelet, APACHE-II score, SOFA score, TCM syndrome score changes compared with the control group, the difference was statistically significant (P0.05). And Dachengqi Decoction retention enema after seventh days and third days compared to the level of detection index improved significantly. Seventh days after treatment in experimental group, the body temperature changes compared with the control group, the difference was statistically significant (P0.05). Conclusion: 1. Dachengqi Decoction retention enema can improve sepsis (stasis resistance type) clinical the efficacy of.2. in patients with Dachengqi decoction retention enema can effectively reduce sepsis (stasis resistance type) patients with coagulation four, two D- dimer and lactate levels, elevated levels of platelet count, improve the patient's breathing and temperature.3. Dachengqi Decoction retention enema The APACHE-II score, SOFA score and TCM syndrome score were effectively reduced in patients with sepsis (blood stasis syndrome).

【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7

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