香砂六君子汤辅助治疗脓毒症致急性胃肠损伤的临床观察

Effects of Xiangsha Liujunzi Decoction Adjuvant Therapy in Patients with Sepsis-induced Acute Gastroin⁃testinal Injury

目的观察香砂六君子汤辅助治疗对脓毒症致急性胃肠损伤患者胃肠黏膜屏蔽功能、胃肠动力及氧化应激反应的影响。方法脓毒症患者60例采用随机数字表法分为对照组与试验组各30例,对照组采用常规治疗,试验组采用常规治疗联合香砂六君子汤治疗。比较治疗前和治疗2周后两组患者的中医症状积分、胃肠黏膜屏蔽功能[D-乳酸浓度、内毒素(ET)、肿瘤坏死因子-α(TNF-α)]、胃肠动力[胃泌素(GAS)、血管活性肠肽(VIP)、胃动素(MOT)]及氧化应激反应[丙二醛(MDA)、血清超氧化物歧化酶(SOD)、抗利尿激素(ADH)]变化情况。结果治疗后,试验组中医证候积分、血清D-乳酸浓度、ET和TNF-α水平均低于对照组(P<0.05);治疗后,试验组MOT水平高于对照组,GAS和VIP水平低于对照组(P<0.05);治疗后,试验组SOD水平高于对照组,MDA和ADH水平低于对照组(P<0.05)。结论香砂六君子汤辅助治疗对改善脓毒症致急性胃肠损伤患者胃肠黏膜屏蔽功能、胃肠动力及氧化应激反应有积极意义。

Objective:To explore the effects of Xiangsha Liujunzi Decoction adjuvant therapy on gastrointestinal mucosal shielding function,gastrointestinal motility and oxidative stress response in patients with sepsis-induced acute gastrointestinal injury.Methods:A total of 60 patients with sepsis in the hospital were selected and divided into the control group and experimental group by random number table method,with 30 cases in each group.The control group received conventional therapy,and the experimental group was given conventional therapy combined with Xiangsha Liujunzi Decoction.The TCM symptoms scores,gastrointestinal mucosal shielding function[D-lactic acid concentration,endotoxin(ET),tumor necrosis factorα(TNF-α)],gastrointestinal motility[gastrin(GAS),va⁃soactive intestinal peptide(VIP),motilin(MOT)]and oxidative stress response[malondialdehyde(MDA),serum superoxide dismutase(SOD),antidiuretic hormone(ADH)]were compared between the two groups before treat⁃ment and after 2 weeks of treatment.Results:After treatment,the TCM syndromes scores in experimental group were lower than those in control group(P<0.05).The levels of serum D-lactic acid concentration,ET and TNF-αin experimental group after treatment were lower than those in control group(P<0.05).After treatment,the MOT level in experimental group was higher than that in control group while levels of GAS and VIP were lower than those in control group(P<0.05).After treatment,SOD level in experimental group was higher while levels of MDA and ADH were lower than those in control group(P<0.05).Conclusion:Xiangsha Liujunzi Decoction adju⁃vant therapy has positive significance on improving the gastrointestinal mucosal shielding function,gastrointestinal motility and oxidative stress response in patients with sepsis-induced acute gastrointestinal injury.