参苓白术散对脓毒症患者肠道功能的影响

Effect of Shenling Baizhu Powder on Intestinal Function in Patients with Sepsis

目的探讨参苓白术散对脓毒症患者肠道功能的影响。方法选取2017年3月~2019年3月我院收治的脓毒症患者82例,随机分为观察组和对照组,各41例。对照组予以抗感染及器官功能支持治疗,观察组在对照组基础上加用参苓白术散治疗,比较两组治疗前后炎性因子指标(IL-6、TNF-α)、肠道通透性指标(DAO、D-LAC)、住ICU时间、急性生理与慢性健康状况评分(APACHEⅡ评分)及病死率。结果治疗后,观察组血清TNF-α、IL-6、DAO、D-LAC水平低于对照组[(38.91±5.18)ng/Lvs(51.34±6.05)ng/L]、[(216.60±16.30)ng/Lvs(327.49±20.42)ng/L]、[(4.01±1.27)IU/Lvs(6.37±1.46)IU/L]、[(8.49±2.37)mg/mlvs(12.61±3.53)mg/ml],差异有统计学意义(P<0.05);观察组APACHEⅡ评分、病死率低于对照组,住ICU时间短于对照组,差异有统计学意义(P<0.05)。结论参苓白术散可减脓毒症患者炎性反应和肠黏膜损伤,改善病情,缩短住ICU时间,降低病死率。

Objective To investigate the effect of Shenling Baizhu Powder on intestinal function in patients with sepsis.Methods 82 patients with sepsis admitted to our hospital from March 2017 to March 2019 were randomly divided into observation group and control group,with 41 cases in each group.The control group received anti-infective and organ function support treatment.The observation group was treated with Shenqi Baizhu Powder on the basis of the control group.The inflammatory factor index(IL-6,TNF-α)and intestinal permeability were compared before and after treatment.Indicators(DAO,D-LAC),ICU time,acute physiology and chronic health status score(APACHEⅡscore),and case fatality rate.Results After treatment,the levels of serum TNF-α,IL-6,DAO and D-LAC in the observation group were lower than those in the control group[(38.91±5.18)ng/L vs(51.34±6.05)ng/L],[(216.60±16.30)ng/L vs(327.49±20.42)ng/L],[(4.01±1.27)IU/L vs(6.37±1.46)IU/L],[(8.49±2.37)mg/ml vs(12.61±3.53)mg/ml],the difference was statistically significant(P<0.05);the APACHEII score and mortality rate of the observation group were lower than that of the control group,and the ICU time was shorter than the control group,the difference was statistically significant(P<0.05).Conclusion Shenling Baizhu Powder can reduce inflammatory reaction and intestinal mucosal injury in patients with sepsis,improve the condition,shorten the time of ICU and reduce the case fatality rate.