生血通便颗粒治疗血虚肠燥型脓毒症胃肠功能损伤的临床研究

Clinical effect of Shengxue Tongbian granules in treatment of gastrointestinal function injury with blood deficiency and intestinal dryness caused by sepsis

目的:观察生血通便颗粒治疗血虚肠燥型脓毒症胃肠功能损伤的临床疗效。方法:将60例血虚肠燥型脓毒症胃肠功能损伤患者随机分为治疗组和对照组,每组各30例。2组均予西医常规基础治疗,对照组在此基础上加用马来酸曲美布汀治疗,治疗组在对照组基础上再加生血通便颗粒治疗,疗程均为14 d。观察2组综合疗效和治疗前后炎症指标[白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)]水平、序贯性器官衰竭(SOFA)积分、胃肠功能损伤积分、腹内压、血清二胺氧化酶(DAO)水平及中医证候积分。结果:总有效率治疗组为86.67%(26/30),明显高于对照组的60.00%(18/30),差异有统计学意义(P<0.05)。治疗后2组炎症指标(WBC、CRP、PCT)水平、SOFA积分、胃肠功能损伤积分、腹内压、DAO水平及中医证候积分较治疗前均有所下降,且治疗组下降幅度均大于对照组,差异有统计学意义(P<0.05或P<0.01)。结论:生血通便颗粒治疗血虚肠燥型脓毒症胃肠功能损伤,能减轻患者炎症反应、降低SOFA和胃肠功能损伤积分、降低腹内压及血清DAO水平、改善中医证候,值得临床推广运用。

Objective: To investigate the clinical effect of Shengxue Tongbian granules in the treatment of gastrointestinal function injury with blood deficiency and intestinal dryness caused by sepsis.Methods: A total of 60 patients with gastrointestinal function injury with blood deficiency and intestinal dryness caused by sepsis were randomly divided into treatment group and control group, with 30 patients in each group.The patients in the control group were given conventional Western medicine treatment and trimebutine maleate, and those in the treatment group were given Shengxue Tongbian granules in addition to the treatment in the control group;the course of treatment was 14 days for both groups.The two groups were compared in terms of overall response and inflammatory markers [white blood cell count(WBC),C-reactive protein(CRP),and procalcitonin(PCT)],Sequential Organ Failure Assessment(SOFA) score, gastrointestinal function injury score, intra-abdominal pressure, serum diamine oxidase(DAO) level, and traditional Chinese medicine(TCM) syndrome score before and after treatment.Results: The treatment group had a significantly higher overall response rate than the control group [86.67%(26/30) vs 60.00%(18/30),P<0.05].After treatment, both groups had significant reductions in inflammatory markers(WBC,CRP,and PCT),SOFA score, gastrointestinal function injury score, intra-abdominal pressure, DAO level, and TCM syndrome score, and the treatment group had significantly greater reductions than the control group(P<0.05 or P<0.01).Conclusion: In the treatment of gastrointestinal function injury with blood deficiency and intestinal dryness caused by sepsis, Shengxue Tongbian granules can alleviate inflammatory response, reduce SOFA score, gastrointestinal function injury score, intra-abdominal pressure, and serum DAO level, and improve TCM syndrome, and therefore, it holds promise for clinical application.