生大黄联合乌司他丁治疗脓毒症伴胃肠功能障碍临床研究
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Clinical Study on Radix Et Rhizoma Rhei Combined with Ulinastatin for Sepsis Complicated with Gastrointestinal Dysfunction
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    摘要:

    目的:观察生大黄联合乌司他丁治疗脓毒症伴胃肠功能障碍患者的临床效果。方法:将 96 例脓毒症合并胃肠功能障碍患者按随机数字表法分为观察组与对照组,各 48 例。对照组在常规西医治疗的基础上予以乌司他丁静脉滴注,观察组在对照组的基础上联合生大黄水煎剂灌胃治疗。比较 2 组肠内营养耐受率,胃肠功能障碍与病情严重程度[急性生理与慢性健康评分(APACHE-II)]评分,胃肠功能改善效果;检测 2 组血生化指标[D-乳酸(D-Lac)、二胺氧化酶(DAO),白细胞介素-6(IL-6)、高迁移率族蛋白 B1(HMGB1)]水平。结果:治疗 7 d,观察组肠内营养耐受率为 81.25%,对照组为 62.50%,2 组比较,差异有统计学意义 (P<0.05)。治疗 7 d,观察组胃肠功能改善总有效率为 95.83%,对照组为 83.33%,2 组比较,差异有统计学意义(P<0.05)。治疗 7 d,观察组胃肠功能障碍与 APACHE-II 评分均低于对照组 (P<0.05)。治疗 7 d,2 组血清 D-Lac、DAO、IL-6、HMGB1 水平均较治疗前降低 (P<0.05),且观察组各项指标均低于对照组 (P<0.05)。结论:生大黄联合乌司他丁可有助于改善脓毒症患者胃肠功能障碍,抑制血清炎症因子水平。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Radix et Rhizoma Rhei combined with ulinastatin for patients with sepsis complicated with gastrointestinal dysfunction. Methods:A total of 96 cases of patients with sepsis complicated with gastrointestinal dysfunction were divided into the observation group and the control group according to the random number table method,48 cases in each group. The control group was given intravenous drip with ulinastatin based on routine western medicine treatment,and the observation group was additionally given water decoction of Radix et Rhizoma Rhei by gavage based on the treatment of the control group. The tolerance rates of enteral nutrition,the scores of gastrointestinal dysfunction and disease severity in Acute Physiological and Chronic Health Evaluation(APACHE- II) and the improvement effect of gastrointestinal function in the two groups were compared. The levels of blood biochemical criterion including D-lactic acid (D-Lac),diamine oxidase(DAO),interleukin-6(IL-6),and high mobility group box protein 1(HMGB1)] in the two groups were observed. Results:After seven days of treatment,the tolerance rate of enteral nutrition was 81.25% in the observation group and 62.50% in the control group,the difference being significant(P<0.05). After seven days of treatment,the total effective rate of gastrointestinal function improvement was 95.83% in the observation group and 83.33% in the control group,the difference being significant(P<0.05). After treatment for seven days,the scores of gastrointestinal dysfunction and APACHE-II in the observation group were lower than those in the control group(P<0.05). After seven days of treatment, the levels of D-Lac,DAO,IL-6 and HMGB1 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the above indexes in the observation group were lower than those in the control group(P<0.05). Conclusion:The therapy of Radix et Rhizoma Rhei combined with ulinastatin can improve the gastrointestinal dysfunction in patients with sepsis and inhibit the levels of inflammatory factors.

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黄璐,舒巧燕.生大黄联合乌司他丁治疗脓毒症伴胃肠功能障碍临床研究[J].新中医,2021,53(4):106-109

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  • 在线发布日期: 2021-02-27
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