中西医结合治疗老年多器官功能障碍综合征的临床观察

Clinical observation of integrated traditional Chinese and western medicine for treating senile patients with multiple organ dysfunction syndrome

目的 :观察老年多器官功能障碍综合征 (MODS)患者的中西医结合治疗效果。方法 :将 1997年1月— 2 0 0 2年 12月住院的 4 6例老年 MODS患者随机分为治疗组 (30例 )和对照组 (16例 )。对照组予以治疗原发病 ,抑制过度应激反应 ,控制感染 ,脏器功能及营养代谢支持等常规治疗 ;治疗组在常规治疗基础上服用益气健脾、活血化瘀中药 (方剂为 :红参 5 g或党参 15 g,黄芪 15 g,白术 12 g,茯苓 15 g,麦芽 30 g,山楂 12 g,鸡内金12 g,生地 30 g,丹参 15 g,三七 6 g,红花 6 g,白芍 15 g) ,并依脏器功能而对症加减 ,每日 1剂。两组各治疗2周 ,观察疗效和患者生活质量变化 (用改良 Barthel指数表 )。结果 :治疗组的显效率及总有效率 (76 .6 7%和93.33% )均优于对照组 (37.5 0 %和 75 .0 0 % ) ,具有显著性差异 (P<0 .0 1和 P<0 .0 5 ) ,同时治疗组患者生活质量提高 ,药物不良反应少见。结论 :益气健脾、活血化瘀中药具有增强体质、促进器官功能、减缓炎症反应的功效 ,且无不良反应 ,适宜老年

Objective: To observe the efficacy of the integrated traditional Chinese and western medicine(TCM WM) in treatment of elderly patients with multiple organ dysfunction syndrome (MODS). Methods: Fortysix gerontal patients with MODS collected from January 1997 to December 2002 were randomly divided into two groups. Control group (n=16) received the conventional therapy such as treatment of primary disease, inhibition of excessive stress, control of infection, maintenance of organ function, and supportive care of nutrition and metabolism, and treatment group (n=30) accepted the conventional therapy plus the Chinese herb with replenishing Qi to invigorate the spleen(益气健脾) as well as promoting blood circulation by removing blood stasis(活血化瘀). The components of the recipe were as follows: 5 g of red ginseng(红参) or 15 g of Dangshen(党参), 15 g of mongolian milkvetch root(黄芪), 12 g of bighead atractylodes rhizome(白术), 15 g of tuckahoe(茯苓), 30 g of malt(麦芽), 12 g of hawthorn fruit(山楂), 12 g of chicken gizzard membrane(鸡内金), 30 g of rehmannia dride rhizome(生地), 15 g of red sage root(丹参), 6 g of notoginseng(三七), 6 g of safflower(红花), and 15 g of white peony root(白芍). The decoction was taken orally once daily, and its components were modified according to the function of organs. The therapeutic efficacy and quality of life (improved Bathel index) were evaluated after 2 weeks. Results: The effectual rate and total effective rate were increased (76 67% vs. 37 50%, P<0 01; 93 33% vs. 75 00%, P<0 05), and the quality of life improved in treatment group, as compared with control group.The side effects of the Chinese drugs were seldom seen. Conclusion: These Chinese drugs are suitable for treating the gerontal patients with MODS because of their reinforcement of the physical fitness, improvement of the organ function, and alleviation of the inflammatory response,and no adverse effects.