调肠方灌肠辅助治疗重症肺炎合并胃肠功能障碍的临床观察

Clinical Observation of Intestinal Conditioning Formula Enema as an Adjuvant Treatment for Severe Pneumonia with Gastrointestinal Dysfunction

目的 观察应用调肠方灌肠治疗重症肺炎(痰热腑实证)合并胃肠功能障碍患者临床疗效及安全性。方法 60例患者随机分为治疗组与对照组各30例,两组患者均接受西医常规基础治疗,治疗组在西医常规治疗的基础上加用调肠方保留灌肠,每次保留灌肠20 min,每日1次,共7 d。观察两组患者治疗前和治疗7 d后炎性指标、胃肠功能指标、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、肺部感染量表(CPIS)和胃肠功能障碍量表(GIDS)评分等,评价调肠方针对痰热腑实型重症肺炎合并胃肠功能障碍疾病的临床疗效及安全性。结果 治疗后,治疗组的胃肠功能指标(AC、IAP)炎性指标[白细胞计数(WBC)、N%、C反应蛋白(CRP)、降钙素原(PCT)]与治疗前对比均有统计学差异(P <0.05),并且低于对照组。治疗后,治疗组的GIDS、APACHEⅡ评分和CPIS均有所下降,且低于对照组(均P <0.05)。治疗组总有效率为83.33%,高于对照组的56.67%(P <0.05)。结论 调肠方灌肠联合西医常规治疗对于重症肺炎胃肠功能障碍(痰热腑实证)具有较好的临床疗效。

Objective:To observe the clinical efficacy and safety of adding intestinal conditioning formula ene-ma to western medicine treatment in patients with severe pneumonia and gastrointestinal dysfunction(syndrome of excessive fu-viscera caused by phlegm-heat).Methods:A total of 60 patients with severe pneumonia and gastro-intestinal dysfunction(syndrome of excessive fu-viscera caused by phlegm-heat)were included in this study,divid-ed equally into a treatment group and a control group,30 patients each.Both groups received standard western medical basic treatment,while the treatment group additionally received intestinal conditioning formula retention enemas.Each enema was retained for 20 minutes,once daily for a total of 7 days.The inflammatory markers,gas-trointestinal function indicators,APACHEⅡ,CPIS,and GIDS scores of both groups were observed before treatment and 7 days after treatment to evaluate the clinical efficacy and safety of the intestinal conditioning formula in treat-ing severe pneumonia with gastrointestinal dysfunction(syndrome of excessive fu-viscera caused by phlegm-heat).Results:After treatment,there were statistically significant differences in the gastrointestinal function indicators(AC,IAP)and inflammatory markers(WBC,N%,CRP,PCT)of the treatment group compared with before treat-ment,and these were lower than those of the control group(P<0.05).After treatment,the GIDS,APACHEII scores,and CPIS of the treatment group decreased,and were lower than those of the control group.Statistical analy-sis showed that the differences after treatment between the two groups were significant(P<0.05).The efficacy of the treatment group(83.33%)was better than that of the control group(56.67%)(P<0.05).Conclusion:Intesti-nal conditioning formula enema combined with standard western medical treatment for patients with severe pneu-monia and gastrointestinal dysfunction(syndrome of excessive fu-viscera caused by phlegm-heat)has shown promising results.