肠胃舒联合西医常规疗法治疗脓毒症肠功能障碍临床研究
发布时间：2018-08-07 17:59
【摘要】：目的:观察肠胃舒联合西医常规疗法治疗脓毒症肠功能障碍患者的临床疗效,并研究其对白细胞计数(WBC)、降钙素原(PCT)、腹腔内压力(IAP)、肠功能障碍评分、急性生理学及慢性健康状况评分系统(APACHE II)评分的影响,探讨肠胃舒对脓毒症肠功能障碍患者的干预机制。为中西医结合治疗脓毒症肠功能障碍提供新的思路。方法:收集2014年9月至2016年9月于河北省中医院重症医学科(ICU)收住院的脓毒症患者,筛选出符合纳入标准的、感染部位明确且伴有肠功能障碍的120例患者作为研究对象,将120例脓毒症肠功能障碍患者随机分为治疗组和对照组各60例。对照组给予西医常规疗法治疗,治疗组在给予西医常规疗法治疗的同时给予肠胃舒1剂/日,浓煎取汁150ml,分上、下午两次鼻饲,方中药物有:大黄9g,蒲公英20g,当归15g,赤芍12g,白芍12g,川芎9g,仙鹤草20g,川黄连6g,清半夏6g,瓜蒌15g,地榆20g,茯苓20g。7d后比较两组患者治疗前后WBC、PCT、IAP、肠功能障碍评分、APACHE II评分的变化情况,评价两组的临床疗效及安全性。结果:1基线资料比较:治疗组60例患者中,男36例,女24例;年龄18-89岁,平均(55.33±14.59)岁。对照组60例患者中,男32例,女28例;年龄21-90岁,平均(56.26±13.94)岁。两组患者的性别、年龄等一般资料比较,差异均无统计学意义(P0.05),具有可比性。2两组患者完成治疗情况比较:两组各纳入研究病例60例,治疗过程中,治疗组脱落1例,剔除1例,最终纳入统计病例58例;对照组脱落4例,剔除2例,最终纳入统计病例54例。3两组患者临床疗效比较:治疗后,治疗组的总有效率为91.38%,对照组为88.89%,治疗组疗效优于对照组,组间比较,差异有统计学意义(Z=-2.471,P0.05)。4两组患者治疗前后WBC、PCT及IAP比较:治疗前,两组患者的WBC、PCT等炎症指标及IAP比较,差异无统计学意义(P0.05);治疗后,两组患者的WBC、PCT等炎症指标及IAP均较治疗前明显改善(P0.01),且治疗组的改善作用均优于对照组,差异均有统计学意义(P0.01)。5两组患者治疗前后肠功能障碍评分、APACHEⅡ评分比较:治疗前,两组患者的肠功能障碍评分、APACHE II评分比较,差异均无统计学意义(P0.05);治疗后,两组患者的肠功能障碍评分、APACHEⅡ评分均明显低于治疗前(P0.01),且治疗组的降低作用均优于对照组,差异均有统计学意义(P0.01)。6不良反应:试验过程中,治疗组有4例出现恶心,对照组有5例出现恶心,均未作处理,1周后症状自行消失。两组患者的肝、肾功能均未见明显异常。结论:本研究表明,在西医常规疗法治疗的基础上加用肠胃舒治疗可减轻脓毒症肠功能障碍患者的炎症反应,改善肠功能障碍,并减轻脓毒症肠功能障碍患者病情的严重程度。
[Abstract]:Objective: to observe the clinical efficacy of Changweishu combined with western medicine in the treatment of septic intestinal dysfunction, and to study the score of (IAP), intestinal dysfunction with leukocyte count (WBC),) and procalcitonin (PCT),) intraperitoneal pressure. Effects of acute physiology and chronic health status scoring system (APACHE II) on the interventional mechanism of Changwei Shu in patients with septic intestinal dysfunction. To provide a new idea for the treatment of sepsis intestinal dysfunction by integrated traditional Chinese and western medicine. Methods: from September 2014 to September 2016, 120 patients with sepsis were collected from (ICU) Department of intensive Medicine, Hebei traditional Chinese Medicine Hospital, and 120 patients with definite infection site and intestinal dysfunction were selected as study objects. 120 patients with septic intestinal dysfunction were randomly divided into treatment group and control group. The control group was treated with routine western medicine therapy, while the treatment group was given 1 dose / day of Changwei Shu while the treatment group was given two times nasal feeding in the afternoon. The drugs included: rhubarb 9g, dandelion 20g, Angelica sinensis 15g, Radix Paeoniae lanceolata 12g, White Peony 12g, Chuanxiong 9g, Herba Celestrae 20g, Chuanghuanglian 6g, Prunus ternata 6g, Trichosanthes 15g, Ulmus pumila 20g, Poria cocos 20g.7d. The changes of WBCPCTTIAPs, intestinal dysfunction score and Apache II were compared between the two groups before and after treatment. To evaluate the clinical efficacy and safety of the two groups. Results comparison of baseline data with 1: 1: in the treatment group, there were 36 males and 24 females, aged 18-89 years with an average age of (55.33 卤14.59) years. In the control group, there were 32 males and 28 females, aged 21-90 years (mean 56.26 卤13.94 years). There was no significant difference in sex, age and other general data between the two groups (P0.05). 2 comparison of the two groups: 60 cases were included in the study, and 1 case was lost in the treatment group. One case was eliminated, 58 cases were included in the statistics, 4 cases dropped out in the control group, 2 cases were eliminated, and 54 cases were included in the statistical case. 3 the clinical curative effect of the two groups was compared: after treatment, The total effective rate of the treatment group was 91.38 and that of the control group was 88.89.The curative effect of the treatment group was better than that of the control group. The difference between the two groups was statistically significant (P 0.05). 4 comparison of IAP and WBC before and after treatment: before and after treatment, the inflammatory indexes and IAP of the two groups were compared. There was no significant difference between the two groups (P0.05). After treatment, the inflammatory indexes such as WBC, PCT and IAP in the two groups were significantly improved compared with those before treatment (P0.01), and the improvement of the treatment group was better than that of the control group. The difference was statistically significant (P0.01) .5 before and after treatment, the intestinal dysfunction score and Apache 鈪，
本文编号：2170873
[Abstract]:Objective: to observe the clinical efficacy of Changweishu combined with western medicine in the treatment of septic intestinal dysfunction, and to study the score of (IAP), intestinal dysfunction with leukocyte count (WBC),) and procalcitonin (PCT),) intraperitoneal pressure. Effects of acute physiology and chronic health status scoring system (APACHE II) on the interventional mechanism of Changwei Shu in patients with septic intestinal dysfunction. To provide a new idea for the treatment of sepsis intestinal dysfunction by integrated traditional Chinese and western medicine. Methods: from September 2014 to September 2016, 120 patients with sepsis were collected from (ICU) Department of intensive Medicine, Hebei traditional Chinese Medicine Hospital, and 120 patients with definite infection site and intestinal dysfunction were selected as study objects. 120 patients with septic intestinal dysfunction were randomly divided into treatment group and control group. The control group was treated with routine western medicine therapy, while the treatment group was given 1 dose / day of Changwei Shu while the treatment group was given two times nasal feeding in the afternoon. The drugs included: rhubarb 9g, dandelion 20g, Angelica sinensis 15g, Radix Paeoniae lanceolata 12g, White Peony 12g, Chuanxiong 9g, Herba Celestrae 20g, Chuanghuanglian 6g, Prunus ternata 6g, Trichosanthes 15g, Ulmus pumila 20g, Poria cocos 20g.7d. The changes of WBCPCTTIAPs, intestinal dysfunction score and Apache II were compared between the two groups before and after treatment. To evaluate the clinical efficacy and safety of the two groups. Results comparison of baseline data with 1: 1: in the treatment group, there were 36 males and 24 females, aged 18-89 years with an average age of (55.33 卤14.59) years. In the control group, there were 32 males and 28 females, aged 21-90 years (mean 56.26 卤13.94 years). There was no significant difference in sex, age and other general data between the two groups (P0.05). 2 comparison of the two groups: 60 cases were included in the study, and 1 case was lost in the treatment group. One case was eliminated, 58 cases were included in the statistics, 4 cases dropped out in the control group, 2 cases were eliminated, and 54 cases were included in the statistical case. 3 the clinical curative effect of the two groups was compared: after treatment, The total effective rate of the treatment group was 91.38 and that of the control group was 88.89.The curative effect of the treatment group was better than that of the control group. The difference between the two groups was statistically significant (P 0.05). 4 comparison of IAP and WBC before and after treatment: before and after treatment, the inflammatory indexes and IAP of the two groups were compared. There was no significant difference between the two groups (P0.05). After treatment, the inflammatory indexes such as WBC, PCT and IAP in the two groups were significantly improved compared with those before treatment (P0.01), and the improvement of the treatment group was better than that of the control group. The difference was statistically significant (P0.01) .5 before and after treatment, the intestinal dysfunction score and Apache 鈪，
本文编号：2170873
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