大黄对多器官功能障碍综合征治疗作用的临床研究

Clinical studies of the therapeutic effects of rhubarb on multiple organ dysfunction syndrome

目的 :研究大黄对多器官功能障碍综合征 (MODS)的治疗作用。方法 :12 9例 MODS患者 ,根据有无胃肠功能障碍分为 MODS伴和不伴胃肠功能障碍组 ,又依据是否应用大黄治疗分为大黄和非大黄治疗组 ,观察几组患者胃肠功能障碍发生率、缓解率、存活率等。结果 :12 9例 MODS患者中 81例伴有胃肠功能障碍 ,其发生率为 6 2 .8%。其中 5 4例患者接受大黄治疗 ,有效率为 6 1.1% ;2 7例患者为非大黄治疗组 ,胃肠功能恢复率为2 5 .9% ,2组间有显著性差异 (P<0 .0 1)。 5 4例 MODS伴胃肠功能障碍患者接受大黄治疗后 ,有 2 8例患者存活 ,存活率为 5 1.9% ;2 7例 MODS伴胃肠功能障碍患者接受其它胃肠动力剂治疗后有 6例患者存活 ,存活率为 2 2 .2 %。 2 9例 MODS不伴胃肠功能障碍的患者接受大黄治疗后有 12例存活 ,存活率为 41.4% ;19例MODS不伴胃肠功能障碍者接受其它胃肠动力剂治疗后 ,有 7例存活 ,存活率为 36 .8%。在累及 4个以上器官的 MODS患者中 ,伴胃肠功能障碍的患者接受大黄治疗后其存活率明显高于非大黄治疗组 (P<0 .0 5 )。结论 :大黄对 MODS有较好的治疗作用 。

Objective:To study the therapeutic effects of rhubarb on multiple organ dysfunction syndrome (MODS).Methods:One hundred and twentynine patients suffered from MODS were divided into gastrointestinal dysfunction and nongastrointestinal dysfunction groups,and further divided into two subgroups:rhubarb treatment group and nonrhubarb treatment group.The survival rate,morbidity of gastrointestinal dysfunction and therapeutic effect of rhubarb were observed.Results:eightyone of 129 MODS patients had gastrointestinal failure and the morbidity of gastrointestinal failure was 62 8%,in whom 54 patients received rhubarb therapy and 33 patients(61 1%) were alleviated.Whereas only 7(25 9%) out of 27 patients suffered from gastrointestinal failure in nonrhubarb treatment group were improved.There was a significant difference between the two groups( P <0 01).Furthermore,28(51 9%) out of 54 MODS patients accompanied by gastrointestinal dysfunction were survived after rhubarb treatment,whereas 6(22 2%) of 27 MODS patients suffered from gastrointestinal dysfunction were survived in nonrhubarb treatment group.Twelve(41 4%) out of 29 MODS patients without gastrointestinal dysfunction were survived after rhubarb treatment,whereas 7(36 8%) of 19 MODS patients without gastrointestinal dysfunction were survived in nonrhubarb treatment group.The survival rate in the MODS patients,whose dysfunction organs involved more than four,was much higher in rhubarb therapy group than those in nonrhubarb treatment group ( P <0 05).Conclusions:Rhubarb has a good curative effects on MODS,whose pharmaceutical mechanisms may function through gastrointestinal ones.