通腑泻下法对危重患者胃肠功能障碍的治疗效果评价

Relaxing Bowels Purging Purgation Effect Evaluation for Treatment of Gastrointestinal Dysfunction in Critical Patients

目的评价通腑泻下法在危重患者胃肠功能障碍治疗中的应用效果。方法将86例伴胃肠功能障碍的危重患者按数字表法随机分为观察组和对照组各43例,两组均给予西医对症支持治疗,在此基础上对照组给予莫沙必利应用,观察组给予通腑泻下法中药应用,两个疗程后对比两组胃肠功能障碍及相关实验室指标改善情况。结果观察组MODS发生率32.56%、死亡率11.63%均低于对照组67.44%、30.23%,总有效率76.74%优于对照组53.49%,便秘、出血、肠鸣音消失、发热等临床症状改善所需时间较对照组缩短,胃肠功能障碍、APACHEⅡ、中医症候等评分均较对照组降低更为明显,差异有统计学意义(P<0.05);观察组治疗后DAO、TNF-α、CRP、PCT等血清水平均低于对照组,差异有统计学意义(P<0.05)。结论通腑泻下法应用于危重患者可抑制患者机体炎症反应,改善肠道屏障功能,纠正胃肠功能障碍,明显改善预后,综合疗效优异。

Objective Evaluation of relaxing bowels, purging of purgation in the treatment of gastrointestinal dysfunction in critical patients with application. Methods 86 patients with functional gastrointestinal disorder by numerical method in critically ill pa- tients randomly assigned to observation group and the control group in 43 cases, both groups were given symptomatic support West- ern medicine treatment, control group of mosapride on the basis of this application, observer group for relaxing bowels, purging pur- gation applied traditional Chinese medicine, after 2 treatments compared two groups of gastrointestinal dysfunction and related labo- ratory measures to improve the situation. Results Observer group MODS cent,mortality 32.56% the incidence is lower than in the control group,67.44% ,total effective rate 76.74% 53.49% better than the control group, constipation, bleeding, bowel sounds disappear, like fever reduction than the control group required to improve clinical symptoms, gastrointestinal dysfunction, APACHE I[ and TCM symptom scores were higher than those in the control group reduce more obvious, a statistically significant difference （P 〈 0.05 ） ; Observer Group after treatment such as DAO, TNF - alpha, CRP, PCT serum levels were lower than the control group, a statistically significant difference （ P 〈 0.05 ）. Conclusion Relaxing bowels, purging purgation applied can suppress the inflammatory reaction in patients with in critically ill patients ,improve intestinal battier function to correct the gastrointestinal dys- function, significantly improved the prognosis, and comprehensive examinations.