加味黄连解毒汤灌肠辅助治疗重症肺炎合并胃肠功能障碍临床研究

Clinical Study on Enema of Modified Huanglian Jiedu Tang for Severe Pneumonia Complicated with Gastrointestinal Dysfunction

目的:观察加味黄连解毒汤灌肠辅助治疗重症肺炎痰热壅肺证合并胃肠功能障碍的临床疗效。方法:选取64例重症肺炎痰热壅肺证合并胃肠功能障碍患者,依据不同的治疗方法分为治疗组和对照组,每组32例。对照组给予抗菌药、胃肠功能保护药、机械通气等对症治疗,治疗组在对照组基础上联合加味黄连解毒汤灌肠治疗。比较2组临床疗效、治疗前后中医证候积分及血清降钙素原(PCT)水平,记录不良反应发生情况。结果:治疗组总有效率93.75%,高于对照组的71.88%,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前降低,治疗组中医证候积分比对照组下降更明显,差异均有统计学意义(P<0.05)。治疗3天与治疗7天,治疗组PCT水平均低于对照组,差异均有统计学意义(P<0.05)。治疗期间,治疗组发生不良反应5例,对照组发生不良反应4例,未经处理均自行缓解。结论:加味黄连解毒汤灌肠辅助治疗重症肺炎痰热壅肺证合并胃肠功能障碍,可以有效减轻患者的临床症状,改善胃肠功能,抑制炎症反应。

Objective: To observe the clinical effect of enema of modified Huanglian Jiedu Tang for severe pneumonia complicated with gastrointestinal dysfunction. Methods: A total of 64 patients with severe pneumonia complicated with gastrointestinal dysfunction were selected and divided into the treatment group and the control group according to different treatment methods, 32 cases in each group. The control group was given antibiotics, gastrointestinal protection medicine,mechanical ventilation and other symptomatic support treatment, and the treatment group was additionally treated with enema of modified Huanglian Jiedu Tang based on the treatment of the control group. The clinical effect, Chinese medicine syndrome score and the level of procalcitonin(PCT) before and after treatment were compared between the two groups, and adverse reactions were recorded. Results:The total effective rate was 93.75% in the treatment group, higher than that of71.88% in the control group, the difference being significant(P<0.05). After treatment, the Chinese medicine syndrome scores in both groups were decreased when compared with those before treatment,and the decrease in the treatment group was more significant than that in the control group, differences being significant(P<0.05). The level of PCT in the treatment group was lower than that in the control group on the 3 rdday and 7 thday of treatment, differences being significant(P<0.05).During treatment,there were five cases of adverse reactions occurred in the treatment group and four cases in the control group, all of which were relieved spontaneously without treatment. Conclusion: The enema of modified Huanglian Jiedu Tang can effectively reduce the clinical symptoms of patients with severe pneumonia complicated with gastrointestinal dysfunction, improve their gastrointestinal function and inhibit inflammation.