通腑消痞方辅助治疗脓毒症致急性胃肠损伤

Observation on the therapeutic effffect of Tongfu Xiaopi Formula as an adjuvant therapy for acute gastrointestinal injury caused by sepsis

目的探讨通腑消痞方辅助治疗脓毒症致急性胃肠损伤的疗效。方法将80例脓毒症致急性胃肠损伤患者按随机数表法分为观察组与对照组。各40例。2组入院后均给予急性胃肠损伤常规西医治疗,观察组联合通腑消痞方治疗。观察2组治疗前后腹围、腹内压、肠鸣音、急性生理与慢性健康评分Ⅱ(APACHEⅡ)、急性胃肠损伤分级评分、胃肠动力指标胃动素(MOT)、血管活性肠肽(VIP)、胃泌素(GAS)、胃肠黏膜屏障指标二胺氧化酶(DAO)、肠脂肪酸结合蛋白(IFABP)、D-乳酸、炎症指标降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)变化,比较2组临床疗效总有效率和不良反应发生情况。结果观察组治疗后腹围、腹内压、APACHEⅡ评分、急性胃肠损伤分级评分、VIP、GAS、DAO、IFABP、D-乳酸、PCT、CRP、IL-6指标均低于对照组(P<0.05);观察组治疗后肠鸣音次数、MOT、临床疗效总有效率均高于对照组(P<0.05);2组均未发生与治疗相关的不良反应。结论通腑消痞方联合常规西医治疗脓毒症致急性胃肠损伤,能够有效改善患者胃肠功能,可能与调节胃肠动力指标、保护胃肠黏膜屏障、抑制炎症反应有关,疗效确切,安全性好。

Objective To explore the therapeutic effect of Tongfu Xiaopi Formula as an adjunctive therapy for acute gastrointestinal injury caused by sepsis.Methods A total of 80 patients with acute gastrointestinal injury caused by sepsis were randomly divided into an observation group and a control group using a random number table,with 40 cases in each group.Both groups were treated with routine western medicine for acute gastrointestinal injury after admission,while the observation group received a combined treatment with Tongfu Xiaopi Formula.The changes in abdominal circumference,intra-abdominal pressure,bowel sounds,the acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ),the acute gastrointestinal injury grading scores,the gastrointestinal motility indicators motilin(MOT),vasoactive intestinal peptide(VIP),gastrin(GAS),the gastrointestinal mucosal barrier indicators diamine oxidase(DAO),intestinal fatty acid binding protein(IFABP),D-lactate,inflammatory indicators procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)were observed in the two groups before and after treatment,and the total effective rate and incidence of adverse reactions were compared between the two groups.Results After treatment,the abdominal circumference,intra-abdominal pressure,APACHE Ⅱ scores,acute gastrointestinal injury grading scores,VIP,GAS,DAO,IFABP,D-lactate,PCT,CRP,and the level of IL-6 were all lower in the observation group than those in the control group(P<0.05).The number of bowel sounds,the MOT level,and the total effective rate were higher in the observation group than those in the control group after treatment(P<0.05).Neither group experienced any treatment-related adverse reactions.Conclusion The combination of Tongfu Xiaopi Formula and conventional western medicine can effectively improve the gastrointestinal function of patients with acute gastrointestinal injury caused by sepsis,which may be related to regulating gastrointestinal motility indicators,protecting the gastrointestinal mucosal barrier,and inhibiting inflammatory reactions.The therapeutic effect is definite and the safety is good.