大黄对脓毒症合并肠麻痹患者的治疗作用

A clinical study of therapeutic effects lf rhubarb on septic patients with toxic paralytic ileus

目的:观察大黄对脓毒症合并中毒性肠麻痹患者的治疗作用及对血清新喋呤的影响。方法:40例脓毒症合并中毒性肠麻痹患者,随机分为大黄治疗组和对照组各20例。对照组采用综合治疗,大黄治疗组在综合治疗的基础上加用大黄。观察二组患者治疗前后血清新喋呤水平的变化,中毒性肠麻痹的缓解率以及14天生存率。结果:二组患者血清新喋呤在24小时后明显升高,大黄治疗组在24、48、72小时血清新喋呤水平较对照组明显降低(P<0.01)。大黄治疗组在治疗后48小时及72小时中毒性肠麻痹的缓解率分别为50%和75%,与对照组比较有显著性差异(P<0.05和P<0.01)。14天生存率明显高于对照组(P<0.05)。结论:大黄能缓解脓毒症患者中毒性肠麻痹,降低血清新喋呤水平,拮抗系统炎症反应,提高患者的生存率。

Objective ：To study the therapeutic effects of rhubarb on septic patients with toxic paralytic ileus, and investigate the effect of rhubarb on serum neopterin levels. Methods ： Forty septic patients with toxic paralytic ileus were randomly divided into two groups. The 20 patients in the control group treated with general medicine and the 20 cases in the rhubarb group treated general medicine plus rhubarb. The changes of neopterin, gut peristalsis and 14-day survival rate were monitored and compared. Results ： Compared with the control group, the levels of neopterin was significantly lower in 24, 48, and 72 hours after rhubarb administration（P 〈 0.01 ）. In the rhubarb＇ group, 55.1% and 75% of patients were recoverd from toxic paralytic ileus in 48 and 72 hours after rhubarb intake. There were significant difference between the rhubarb group and the control group （ P 〈 0.05 and P 〈 0.01 ）. The study revealed that the 14 day survival rate in the rhubarb group was much higher than the control group（ P 〈 0.05 ）. Conclusions：Rhubarb can effectively relieve toxic paralytic ileus and reduce the serum levels of neopterin in sepsis patients, and also obviously improves the survival rate of sepsis patients.