清热泻瘀对创伤性休克后胃肠功能障碍并多器官功能障碍综合征的疗效及可能机制

Therapeutic Effect and Possible Mechanism of Clearing Away Heat and Removing Blood Stasis on Patients with Gastrointestinal Dysfunction and Traumatic Multiple Organ Dysfunction Syndrome after Traumatic Shock

目的:探究自拟通腑泄瘀汤对创伤性休克后胃肠功能障碍并多器官功能障碍综合征(MODS)患者的疗效及可能机制.方法:选取笔者所在医院2017年2月-2019年1月收治的创伤性休克后胃肠功能障碍并MODS患者92例,采用摸球法分为A组和B组,各46例.两组均给予常规治疗,A组辅以自拟通腑泄瘀汤治疗.治疗1周后观察效果,包括脱离呼吸机时间、ICU监护时间、胃肠道功能恢复时间,以及治疗前后白细胞介素-6、白细胞介素-10、肿瘤坏死因子-α等指标变化.结果:A组脱离呼吸机时间、ICU监护时间、胃肠道功能恢复时间均优于B组,差异均有统计学意义(P<0.05).治疗后,A组白细胞介素-6、白细胞介素-10、肿瘤坏死因子-α均低于B组及同组治疗前,差异均有统计学意义(P<0.05).结论:自拟通腑泄瘀汤在创伤性休克后胃肠功能障碍并MODS患者治疗中具有显著效果,缩短治疗时间,减轻患者炎症反应,值得应用于临床推广.

Objective:To explore the therapeutic effect and possible mechanism of Tongfu Xieyu Decoction on patients with gastrointestinal dysfunction and multiple organ failure syndrome(MODS)after traumatic shock.Method:Ninety-two patients with post-traumatic shock gastrointestinal dysfunction and MODS were selected and divided into group A and group B by touching balls,46 cases in each group.Both groups were given routine treatment,while group A was supplemented by Tongfu Xieyu Decoction.One week after treatment,the effects were observed,including the time of ventilator detachment,ICU monitoring,recovery time of gastrointestinal function,changes of interleukin-6,interleukin-10 and tumor necrosis factor-alpha before and after treatment.Result:The time of ventilator detachment,ICU monitoring and recovery of gastrointestinal function in group A were better than those in group B,the differences were statistically significant(P<0.05).After treatment,the indexes of interleukin-6,interleukin-10 and tumor necrosis factor-alpha in group A were lower than those in group B and the same group before treatment,the differences were statistically significant(P<0.05).Conclusion:Tongfu Xiayu Decoction has a significant effect on the treatment of gastrointestinal dysfunction complicated with MODS after traumatic shock.It is worthy of clinical application to shorten the treatment time and reduce the inflammatory reaction of patients.