小檗碱对脓毒症急性胃肠损伤患者的临床疗效研究

Clinical observation of berberine on sepsis patients with acute gastrointestinal injury

目的:探讨小檗碱对脓毒症急性胃肠损伤(AGI)患者临床疗效及预后的影响。方法:收集我院收治的脓毒症合并AGI患者60例,随机分为观察组(30例)和对照组(30例),两组均予常规对症干预治疗,观察组在对照组基础上联用小檗碱;治疗7 d后,比较两组的胃肠功能评分、外周血清肠道屏障功能标志物和炎性因子水平、急性生理与慢性健康(APACHEⅡ)评分、序贯性脏器衰竭评估(SOFA)评分的变化,以及ICU住院时间、机械通气时间、28 d死亡率。结果:随着治疗时间推移,在治疗后第3、5、7天,两组胃肠功能评分均较治疗前逐渐下降(P均<0.05),且观察组较对照组更明显(P均<0.05)。治疗7 d后,两组二胺氧化酶(DAO)、D-乳酸(D-Lac)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)水平以及APACHEⅡ评分、SOFA评分均显著降低(P<0.05),且观察组较对照组更低(P<0.05)。观察组患者的ICU住院时间、机械通气时间以及28 d死亡率亦明显低于对照组(P<0.05)。结论:应用小檗碱治疗脓毒症AGI患者可以显著改善胃肠功能,减轻炎症反应,缩短疗程,降低死亡率,具有良好的临床疗效。

Objective It is to investigate the influence of curative effect and prognostic of berberine(BER)on sepsis patients with acute gastrointestinal injury(AGI).Methods Totally 60 sepsis patients with AGI in our hospital were selected and randomly divided into the observation group and the control group.Both groups were received routine symptomatic intervention treatment,and the observation group was received BER therapy additionally.After 7 days of treatment,gastrointestinal function scores,the levels of intestinal barrier markers and inflammatory factors in peripheral serum,acute physiology and chronic health evaluation(APACHEⅡ)scores and sequential organ failure assessment(SOFA)scores of the two groups were compared.And the duration of staying in ICU,mechanical ventilation time and 28-day mortality of the two groups were compared.Results As the treatment progresses,on the 3rd,5th,and 7th day of treatment,the gastrointestinal function scores of two groups were decreased gradually compared with that before treatment(P<0.05),but the observation group was lower(P<0.05).After 7 days of treatment,the levels of diamine oxidase(DAO)and D-lactic acid(D-Lac),the levels of c-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT),APACHEⅡscores and SOFA scores of the two groups were significantly lower than before(P<0.05),but the observation group were lower(P<0.05).The duration of staying in ICU and mechanical ventilation time,28-day mortality of the observation group were significantly lower than that in the control group(P<0.05).Conclusion Berberine could better improve gastrointestinal function,reduce the inflammation,shorten the course of treatment,reduce the mortality,and had good clinical efficacy in sepsis patients with AGI.