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[目的]观察加味黄连解毒汤联合西药治疗多器官功能障碍综合征(MODS)疗效。[方法]使用随机平行对照方法,将22例住院患者按就诊顺序号方法简单分为两组。对照组10例对症支持治疗:(1)控制原发病;(2)功能不全器官支持治疗(保障循环、呼吸系统功能);(3)代谢支持和调理;(4)连续肾脏替代治疗。治疗组12例加味黄连解毒汤(黄连、黄柏、黄芩、栀子、生大黄各10g),根据意识鼻饲(浓煎,50mL/次)或口服(100mL/次);西药治疗同对照组。连续治疗5d为1疗程。观测临床症状、TLR4表达、APACHEⅢ评分、不良反应。治疗1疗程,判定疗效。[结果]治疗组好转9例,死亡2例,自动出院1例,好转率75.00%;对照组好转3例,死亡5例,自动出院2例,好转率30.00%;治疗组疗效优于对照组(P<0.05)。TLR4表达、APACHEⅢ评分治疗组优于对照组(P<0.05)。[结论]加味黄连解毒汤联合西药治疗多器官功能障碍综合征(MODS),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Modified Huanglian Jiedu Decoction combined with western medicine on multiple organ dysfunction syndrome (MODS). [Methods] Using randomized parallel control method, 22 inpatients were divided into two groups according to the sequence number of visiting doctor. Control group, 10 cases of symptomatic and supportive treatment: (1) control of the primary disease; (2) insufficiency of organ support treatment (protection of circulation, respiratory system function); (3) metabolism support and conditioning; (4) continuous renal replacement therapy. In the treatment group, 12 cases were treated with flavonoid Huanglian Jiedu Decoction (Coptis chinensis, Cortex phellodendri, Scutellaria baicalensis, Fructus Gardeniae and Rhubarb each 10g) according to the conscious nasal feeding (concoction, 50mL / time) or oral (100mL / time); Continuous treatment of 5d for a course of treatment. Clinical symptoms, TLR4 expression, APACHE III score and adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Results] The treatment group improved in 9 cases, 2 died, 1 case was discharged automatically, the improvement rate was 75.00%; 3 cases improved in the control group, 5 cases died and 2 cases were discharged automatically, the improvement rate was 30.00%. The curative effect of the treatment group was better than that of the control group (P <0.05). TLR4 expression, APACHE Ⅲ score treatment group than the control group (P <0.05). [Conclusion] Modified Huanglian Jiedu Decoction combined with western medicine in the treatment of multiple organ dysfunction syndrome (MODS) has satisfactory curative effect and no serious adverse reactions and is worth popularizing.