生大黄水煎液灌肠联合哌拉西林他唑巴坦治疗深Ⅱ度烧伤并脓毒症临床评价

Clinical Evaluation of Enema with Raw Rhei Radix et Rhizoma Water Decoction Combined with Piperacillin and Tazobactam in the Treatment of Deep Second Degree Burn Complicated with Sepsis

目的探讨生大黄水煎液灌肠联合哌拉西林他唑巴坦治疗深Ⅱ度烧伤并脓毒症的临床疗效。方法选取医院2022年1月至12月收治的深Ⅱ度烧伤并脓毒症患者62例,按治疗方案的不同分为对照组(36例)和观察组(26例)。两组患者均给予补充血容量、营养支持、增强免疫等常规综合辅助治疗,同时予注射用哌拉西林钠他唑巴坦钠静脉滴注。观察组患者加用生大黄水煎液灌肠。两组均连续治疗7 d。结果观察组总有效率为61.54%,明显高于对照组的41.67%(P<0.05)。治疗7 d后,两组患者急性生理学和慢性健康状况评价Ⅱ评分、序贯器官衰竭评分及降钙素原、C反应蛋白、肿瘤坏死因子-α、白细胞介素6水平均明显降低(P<0.05),且观察组明显低于对照组(P<0.05),免疫球蛋白(Ig)M、T淋巴细胞亚群(CD_(4)^(+)、CD_(8)^(+))水平及CD_(4)^(+)/CD_(8)^(+)均明显升高(P<0.05),且除CD_(8)^(+)外,观察组其余指标均明显高于对照组(P<0.05)。两组不良反应发生率相当(P>0.05)。结论生大黄水煎液灌肠联合哌拉西林他唑巴坦治疗深Ⅱ度烧伤并脓毒症,可有效缓解患者的临床症状,保护各器官系统功能,减轻炎性反应,改善免疫功能。

Objective To investigate the clinical efficacy of enema with raw Rhei Radix et Rhizoma water decoction combined with piperacillin and tazobactam in the treatment of deep second degree burn complicated with sepsis.Methods A total of 62 patients with deep second degree burn and sepsis admitted to the hospital from January to December 2022 were selected and divided into the control group(36 cases)and the observation group(26 cases)according to different treatment plans.Both groups were given routine comprehensive adjuvant treatment(blood volume supplementation,nutritional support,immunity enhancing)and intravenous drip of Piperacillin Sodium and Tazobactam Sodium for Injection.On this basis,the patients in the observation group were given the enema with raw Rhei Radix et Rhizoma water decoction.Both groups were treated continuously for 7 d.Results The total effective rate in the observation group was 61.54%,which was significantly higher than 41.67%in the control group(P<0.05).After 7 d of treatment,the Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,Sequential Organ Failure Assessment(SOFA)score,procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in the two groups significantly decreased(P<0.05),and those in the observation group were significantly lower than those in the control group(P<0.05).After 7 d of treatment,the immunoglobulin(Ig)M,T lymphocytes(CD_(4)^(+),CD_(8)^(+))levels and CD_(4)^(+)/CD_(8)^(+)in the two groups significantly increased(P<0.05),and those(except for CD_(8)^(+))in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions was similar between the two groups(P>0.05).Conclusion Enema with raw Rhei Radix et Rhizoma water decoction combined with piperacillin and tazobactam in the treatment of deep second degree burn complicated with sepsis can effectively relieve the clinical symptoms,protect the functions of various organs and systems,reduce inflammatory reactions and improve immune function of patients.