补中益气汤联合西医常规疗法对脓毒症继发胃肠功能障碍患者胃肠功能及预后的影响

Effect of Buzhong Yiqi Decoction combined with conventional western medicine therapy on gastrointestinal function and prognosis in patients with sepsis-induced gastrointestinal dysfunction

目的观察补中益气汤联合西医常规疗法对脓毒症继发胃肠功能障碍患者胃肠功能及预后的影响。方法将63例脓毒症继发胃肠功能障碍患者随机分为治疗组(31例)和对照组(32例),对照组在西医常规治疗的基础上加用多潘立酮,治疗组在西医常规治疗的基础上加用补中益气汤。两组疗程均为14 d,比较第二版急性生理和慢性健康(APACHEⅡ)评分、序贯器官功能衰竭(SOFA)评分,以及白细胞计数(WBC)以及C反应蛋白(CRP)、降钙素原(PCT)、胃泌素(GAS)、胃动素(MTL)水平的变化情况。结果 (1)治疗过程中,治疗组脱落1例,对照组脱落2例,最终完成试验者60例,治疗组、对照组各30例。(2)治疗前后组内比较,两组APACHEⅡ、SOFA评分均降低(P<0.01);组间治疗后比较,治疗组APACHEⅡ、SOFA评分低于对照组(P<0.05)。(3)治疗前后组内比较,两组WBC、CRP、PCT水平均下降(P<0.01);组间治疗后比较,治疗组WBC、CRP、PCT水平低于对照组(P<0.05)。(4)治疗前后组内比较,两组GAS、MTL水平均升高(P<0.01);组间治疗后比较,治疗组GAS、MTL水平高于对照组(P<0.05)。结论补中益气汤联合西医常规疗法能有效降低脓毒症继发胃肠功能障碍患者的炎症指标,提高胃肠激素水平,促进胃肠功能恢复,进而改善病情及预后。

Objective To observe the effect of Buzhong Yiqi Decoction combined with conventional western medicine therapy on gastrointestinal function and prognosis in patients with sepsis-induced gastrointestinal dysfunction. Methods Sixty-three patients with sepsis-induced gastrointestinal dysfunction were randomly divided into treatment group(31 cases) and control group(32 cases). The control group was treated with domperidone besides conventional western medicine treatment, while the treatment group was treated with Buzhong Yiqi Decoction besides conventional western medicine treatment. The course of treatment was 14 days in both groups. The changes of the second edition of acute physiological and chronic health(APACHE Ⅱ) scores, sequential organ failure(SOFA) scores, level of white blood cell count(WBC), C-reactive protein(CRP), procalcitonin(PCT), gastrin(GAS) and motilin(MTL) were compared. Results(1)During the treatment,1 case dropped out in the treatment group and 2 cases dropped out in the control group. Finally,60 cases completed the test,30 cases in the treatment group and 30 cases in the control group.(2)The scores of APACHE Ⅱ and SOFA in both groups decreased after treatment( P<0.01);After treatment,APACHE Ⅱ and SOFA scores in the treatment group were lower than those in the control group( P<0.05).(3)The levels of WBC,CRP and PCT in the two groups decreased after treatment( P<0.01). After treatment,the levels of WBC,CRP and PCT in the treatment group were lower than those in the control group( P<0.05).(4)The levels of GAS and MTL in both groups increased after treatment( P<0.01);After treatment,the levels of GAS and MTL in the treatment group were higher than those in the control group( P<0.05). Conclusion Buzhong Yiqi Decoction combined with conventional western medicine therapy can effectively reduce the inflammatory indexes,improve the level of gastrointestinal hormones,promote the recovery of gastrointestinal function,and further improve the disease condition and prognosis of patients with sepsis-induced gastrointestinal dysfunction.