新加黄龙汤治疗ICU脓毒症胃肠功能障碍的疗效观察

Therapeutic effect of Xinjia Huanglong decoction on gastrointestinal dysfunction in ICU sepsis

目的探讨新加黄龙汤治疗ICU脓毒症胃肠功能障碍的疗效。方法选择2018年7月~2019年6月在我院ICU治疗的脓毒症患者60例为研究对象,随机分为观察组与对照组,各30例。对照组给予常规治疗,观察组在此基础上给予新加黄龙汤治疗。比较两组治疗后急性生理与慢性健康评分Ⅱ(Acute physiology and chronic health evaluationⅡ,APACHEⅡ)、器官衰竭序贯评分量表(Sequential organ failure asesment,SOFA)评分、白细胞计数、降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)、胃肠功能障碍评分、腹围、肠鸣音、大便潜血等。结果治疗后,两组APACHEⅡ评分显著低于治疗前,差异有统计学意义(P<0.05);治疗后,观察组APACHEⅡ评分显著低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SOFA评分显著低于治疗前,差异有统计学意义(P<0.05);治疗后观察组SOFA评分显著低于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞计数、CRP水平、降钙素原水平显著低于治疗前,差异有统计学意义(P<0.05);治疗后,观察组白细胞计数、CRP水平、降钙素原水平显著低于对照组,差异有统计学意义(P<0.05)。治疗后两组肠功能障碍评分显著下降,腹围缩小,肠鸣音增加,大便潜血阳性率下降,与治疗前比较,差异有统计学意义(P<0.05);治疗后,观察组肠功能障碍评分、腹围、大便潜血阳性率显著低于对照组,肠鸣音显著高于对照组,差异有统计学意义(P<0.05)。结论新加黄龙汤能改善ICU脓毒症胃肠功能够障碍,改善预后。

Objective To investigate the efficacy of Xinjia Huanglong decoction in the treatment of gastrointestinal dysfunction in ICU sepsis. Methods A total of 60 patients with sepsis treated with ICU in our hospital from July 2018 to June 2019 were enrolled in the study. They were randomly divided into observation group and control group, with 30 cases in each group. The control group was given conventional treatment, and the observation group was given the treatment of Xinjia Huanglong decoction based on the above treatment. The APACHEⅡ(Acute Physiology and Chronic Health EvaluationⅡ) score, SOFA(Sequential Organ Failure Asesment) score, white blood cell count, PCT(procalcitonin),CRP(C-reactive protein), gastrointestinal dysfunction score, abdominal circumference, bowel sounds, fecal occult blood were compared between the two groups after treatment. Results After treatment, the APACHE Ⅱ scores of the two groups were significantly lower than those before treatment(P<0.05). The APACHEⅡ scores of the observation group after treatment were significantly lower than those of the control group, and the difference was statistically significant(P<0.05). After treatment, the SOFA scores of the two groups were significantly lower than those before treatment(P<0.05). The SOFA scores of the observation group were significantly lower than those of the control group after treatment(P<0.05). After treatment, the white blood cell count, CRP and procalcitonin levels in two groups were significantly lower than those before treatment, and the difference was significant(P<0.05). After treatment, the white blood cell count, CRP and procalcitonin in the observation group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05). After treatment, the scores of intestinal dysfunction in the two groups decreased significantly, the abdominal circumference was reduced, the bowel sounds increased, and the positive rate of fecal occult blood decreased, and the difference was statistically significant(P<0.05). After treatment, the dysfunction score, abdominal circumference, and fecal occult blood positive rate in the observation group were significantly lower than those in the control group, and the bowel sound was significantly higher than that of the control group, and the difference was statistically significant(P<0.05). Conclusion Xinjia Huanglong decoction can improve the gastrointestinal dysfunction and improve the prognosis of ICU sepsis.