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目的观察温脾理气通腑法治疗脓毒症胃肠功能障碍的临床疗效。方法将70例患者随机分为治疗组和对照组,每组35例,两组均给予西医常规治疗,治疗组在西医常规治疗的基础上,联合温脾理气通腑法治疗,疗程均为6 d,观察两组胃肠功能障碍评分、中医症候积分、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、ICU停留时间、28天死亡率和多器官功能障碍综合征(MODS)的发生率、C反应蛋白(CPR)及降钙素原(PCT)的变化。结果治疗后治疗组总有效率为90%,肠胃功能障碍、中医临床症候、APACHEⅡ评分分别从(7.85±4.90)、(13.05±4.50)、(23.85±4.30)下降到(2.15±1.80)、(4.06±3.30)、(10.00±3.30);对照组总有效率为70%,肠胃功能障碍、中医临床候诊、APACHEⅡ评分分别从(7.28±4.10)、(12.96±3.60)、(22.96±4.50)下降到(4.86±2.30)、(9.46±4.20)、(15.44±4.20),治疗组改善程度优于对照组,差异有统计学意义(P<0.05);治疗后两组PCT、CRP均较治疗前明显下降,差异有统计学意义(P<0.05),且治疗组较对照组下降更为明显,差异有统计学意义(P<0.05);治疗组MODS发生率、ICU停留时间亦明显低于对照组,差异有统计学意义(P<0.05),但28天死亡率两组比较差异无统计学意义(P>0.05)。结论温脾理气通腑法可有效改善脓毒症患者的胃肠功能,抑制机体炎症反应,降低MODS的发生。
Objective To observe the therapeutic effect of Wenpi Liqi Tongfu on gastrointestinal dysfunction in sepsis. Methods Seventy patients were randomly divided into treatment group and control group, with 35 cases in each group. Both groups were given routine western medicine treatment. The treatment group was treated with routine therapy of Western medicine combined with Wenpi Liqi Tongfu Method, and the treatment course was 6 d. Observe the gastrointestinal dysfunction score, TCM symptom score, acute physiology and chronic health Ⅱ (APACHEⅡ) score, ICU stay time, 28-day mortality and incidence of multiple organ dysfunction syndrome (MODS), C reaction Protein (CPR) and procalcitonin (PCT) changes. Results After treatment, the total effective rate was 90%. The gastrointestinal dysfunction, clinical symptoms and APACHE Ⅱ scores decreased from (7.85 ± 4.90) and (13.05 ± 4.50) and (23.85 ± 4.30) to (2.15 ± 1.80 and 4.06 ± 3.30) and (10.00 ± 3.30) respectively. The total effective rate was 70% in control group. The gastrointestinal dysfunction, TCM clinical waiting time and APACHEⅡscore decreased from (7.28 ± 4.10), (12.96 ± 3.60) and (22.96 ± 4.50) (4.86 ± 2.30), (9.46 ± 4.20) and (15.44 ± 4.20) in the treatment group were better than those in the control group (P <0.05). After treatment, the PCT and CRP levels in both groups were significantly higher than those before treatment (P <0.05), and the treatment group decreased more significantly than the control group, the difference was statistically significant (P <0.05); the incidence of MODS in the treatment group, ICU residence time was significantly lower than the control Group, the difference was statistically significant (P <0.05), but the 28-day mortality was no significant difference between the two groups (P> 0.05). Conclusion Wenpi Liqi Tongfu method can effectively improve gastrointestinal function in patients with sepsis, inhibit the body inflammatory response, reduce the incidence of MODS.