大承气汤联合西医常规治疗干预脓毒症伴急性胃肠损伤的临床研究

Clinical study of Dachengqi Decoction combined with conventional treatment of western medicine to intervene sepsis with acute gastrointestinal injury

目的:观察大承气汤联合西医常规治疗干预脓毒症伴急性胃肠损伤的临床疗效。方法:将40例脓毒症伴急性胃肠损伤患者随机分为治疗组和对照组,每组20例。对照组予常规基础治疗,治疗组在对照组治疗基础上联合大承气汤治疗。两组疗程均为7d。观察比较SOFA评分、APACHEⅡ评分、AGI评分、腹内压、肠鸣音及血清PCT、IL-6、TNF-α、IL-10水平的变化情况。结果:①治疗前后组内比较,两组SOFA评分、APACHEⅡ评分均明显降低(P<0.05);组间治疗后比较,治疗组SOFA评分、APACHE Ⅱ评分均低于对照组(P<0.05)。②治疗前后组内比较,两组腹内压、AGI评分均明显下降(P<0.05),肠鸣音明显增加(P<0.05)。组间治疗后比较,治疗组腹内压、AGI评分低于对照组,而肠鸣音明显多于对照组(P<0.05)。③治疗前后组内比较,两组PCT、IL-6、TNF-α水平均明显下降(P<0.05),IL-10水平明显升高(P<0.05)。组间治疗后比较,治疗组PCT、IL-6、TNF-α水平低于对照组,而IL-10水平明显高于对照组(P<0.05)。结论:大承气汤联合西医常规治疗脓毒症伴急性胃肠损伤,可有效促进患者胃肠功能的恢复,抑制炎症反应。

Objective:To observe the clinical efficacy of Dachengqi Decoction on sepsis with acute gastrointestinal injury.Methods:Forty patients suffering from sepsis with acute gastrointestinal injury were randomly divided into the treatment group and control group,20 cases in each group.The control group was given routine treatment,and the treatment group was treated with Dachengqi Decoction on the basis of routine treatment.The treatment course of both groups was 7 days.The SOFA score,APACHE Ⅱ score,AGI score,intra-abdominal pressure,bowel sounds,and PCT,IL-6,TNF-α and IL-10 levels in serum were observed and compared.Results:①The SOFA score and APACHE Ⅱ score in the two groups decreased significantly after treatment(P<0.05).And those scores in the treatment group were lower than those in the control group(P<0.05).②After treatment,the intra-abdominal pressure and AGI scores in both groups were significantly decreased(P<0.05),and the bowel sounds were significantly increased(P<0.05).The intra-abdominal pressure and AGI scores in the treatment group were lower than those in the control group,and the bowel sounds in the treatment group were significantly more than those in the control group(P<0.05).③After treatment,the levels of PCT,IL-6 and TNF-α in serum in both groups decreased significantly(P<0.05),and the level of IL-10 increased significantly(P<0.05).The levels of PCT,IL-6 and TNF-αin the treatment group were significantly lower than those in the control group(P<0.05),and the levels of IL-10 in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion:Dachengqi Decoction combined with western medicine in the treatment of sepsis with acute gastrointestinal injury can effectively promote the recovery of gastrointestinal function and inhibit inflammatory reaction.