大黄对创伤性休克患者胃肠功能障碍及多器官功能不全综合征的治疗作用

Clinical studies of therapeutic effects of rhubarbon on gastrointestinal dysfunction and multiple organ dysfunction syndrome after traumatic shock

目的 研究中药大黄对创伤性休克后胃肠功能障碍的治疗及其对多器官功能不全综合征 (MODS)的防治作用。 方法 137例创伤性休克后胃肠功能障碍患者 ,分为大黄治疗组和非大黄治疗组 ,观察两组患者胃肠功能障碍的缓解率、缓解时间 ,测定治疗后血浆内毒素和肿瘤坏死因子 -α(TNF -α )的水平 ,MODS的发生率、病死率等。 结果 本组中 71例接受大黄治疗后 ,胃肠功能障碍的缓解率为 87.32 % (6 2 71) ;6 6例患者为非大黄治疗组 ,胃肠功能缓解率为4 8.4 8% (32 6 6 ) ,两组间比较 ,差异有非常显著性意义 (P <0 .0 1)。大黄治疗组胃肠功能障碍持续时间明显缩短。患者接受大黄治疗后 ,血浆中内毒素与TNF -α的水平较非大黄组明显降低。大黄治疗组与非大黄治疗组MODS的发生率分别为 2 9.5 8%、5 1.5 2 % ,MODS的病死率分别为2 3.81%、5 5 .88% ,两组间比较 ,差异有非常显著性意义 (P <0 .0 1)。 结论 大黄对创伤性休克后胃肠功能障碍有显著疗效 。

Objective To study the therapeutic effects of rhubarbon on gastrointestinal dysfunction after traumatic shock and its protective effect on multiple organ dysfunction syndrome (MODS). Methods A total of 137 patients suffering from gastro intestinal dysfunction after traumatic shock were divided into rhubarb treatmentgroup and non rhubarb treatment group. The therapeutic effects and the duration of gastrointestinal dysfunction were observed. Levels of plasma endotoxin and tumor necrosis factor α (TNF α) were measured. Morbidity and mortality rates of MODS were compared between two groups of patients. Results Of 71 patients with gastrointestinal dysfunc tion who received rhubarb treatment, 62 patients (87.32%) got catabatic. Whereasthe gastrointestinal function of only 32 patients (48.48%) out of 66 patients in the non rhubarb treatment group were improved. There was a significant difference between the two groups ( P <0.01). Furthermore, the duration of gastrointestinal dysfunction was decreased significantly in the rhubarb treatment group ( P <0.01). The levels of endotoxin and TNF α in serum were decreased significantly compared with that in the non-rhubarb treatment group. The morbidity of MODS decreased from 51.52% to 29.58% and the mortality rate from 55.88% to 23.81% after treatment with rhubarb, with a significant difference ( P < 0.01 ). Conclusions Rhubarb has a good curative effect on gastrointestinal dysfunction after traumatic shock, which redounds to a decrease of morbidity and mortality rates of MODS.