中药抗炎灵对腹部外科多器官功能障碍综合征患者胃肠激素改变的影响

Alteration of gastrointestinal hormone in multiple organ dysfunction syndrome after abdominal surgery and the curative effects of kangyanling(抗炎灵)

目的 :观察腹部外科术后多器官功能障碍综合征 (MODS)患者血液中胃肠道激素水平的变化和中药抗炎灵的治疗效果 ,探讨抗炎灵治疗腹部外科 MODS的作用机制。方法 :将 4 2例外科手术后并发 MODS患者按入院顺序随机分为两组治疗。治疗组 19例患者于 MODS发生后应用中药抗炎灵治疗 ,对照组 2 3例患者给予等量生理盐水。分别测定两组 MODS发生前及发生后 1d、3d、5 d血浆 (清 )胃泌素、胃动素、血管活性肠肽和生长抑素水平。结果 :腹部外科术后 MODS患者血液中胃肠道激素水平明显降低 ,随着 MODS病情的减轻 ,血液中胃肠激素水平逐渐上升。抗炎灵可促进血中胃肠激素水平的上升。结论 :胃肠激素分泌下降致使胃肠运动受到抑制 ,引起细菌移位可能是发生腹部外科术后 MODS的重要原因 ;中药抗炎灵可促进胃肠激素的分泌 ,促进胃肠运动的恢复 ,减轻肠道细菌移位 ,这可能是抗炎灵治疗 MODS的重要机制之一。

Objective:To observe the alteration of gastrointestinal hormone level in multiple organ dysfunction syndrome(MODS) patients after abdominal surgery,the curative effects of Kangyanling(抗炎灵) on MODS and its mechanisms.Methods:Fortytwo MODS patients after abdominal surgery were randomly divided into two groups.Treatment group ( n =19)was treated with Kangyanling(抗炎灵) for 3 days after being diagnosed MODS,and control group ( n=23 ) was treated with same volumn normal saline.The level of gastrointestinal hormones as plasma gastrin(GAS),motilin(MTL),vasoactive intestinal polypeptide(VIP) and somatostatin (SS) were measured before MODS,1st day,3rd day and the 5th day after MODS respectively were measured with the same method in two groups.Results:The level of plasma GAS,MTL,VIP and SS in MODS patients decreased significantly,then increased gradually following with the lightening of MODS' state.Kangyanling can promote recovery of gastrointestinal hormones in plasma.Conclusion:The decrease of gastrointestinal hormones level can inhibit the movement of gastrointestinal tract and give rise to bacterial translocation, which perhaps are the important cause of MODS after abdominal surgery.Kangyanling can promote secretion of gastrointestinal hormone,and restore the gastrointestinal tract movement,and reduce the gut bacterial translocation,which perhaps are the mechanisms of Kangyanling for treating MODS after abdominal surgery.