大黄附子汤治疗脓毒症致急性胃肠损伤的临床研究
Clinical study of Dahuang Fuzi Decoction in treatment of acute gastrointestinal injury caused by sepsis
- 上海中医药大学学报 2022年36卷第S1期 页码：16-19
- 作者机构：
1.上海中医药大学附属曙光医院急诊科（上海 201203）
2.上海交通大学附属第六人民医院重症监护室（上海 200233）
- 作者简介：
韩丹，女，在读博士生，主治医师，主要从事中医急诊临床研究
王倩，主任医师；E-mail：13564635813@163.com
- 基金信息：上海市卫健委科研项目(20204Y0473)
DOI：10.16306/j.1008-861x.2022.S1.004
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韩丹,吴芳,黎林等.大黄附子汤治疗脓毒症致急性胃肠损伤的临床研究[J].上海中医药大学学报,2022,36(S1):16-19.
HAN dan,WU Fang,LI Lin,et al.Clinical study of Dahuang Fuzi Decoction in treatment of acute gastrointestinal injury caused by sepsis[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(S1):16-19.
韩丹,吴芳,黎林等.大黄附子汤治疗脓毒症致急性胃肠损伤的临床研究[J].上海中医药大学学报,2022,36(S1):16-19. DOI： 10.16306/j.1008-861x.2022.S1.004.
HAN dan,WU Fang,LI Lin,et al.Clinical study of Dahuang Fuzi Decoction in treatment of acute gastrointestinal injury caused by sepsis[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(S1):16-19. DOI： 10.16306/j.1008-861x.2022.S1.004.
摘要
目的,2,观察大黄附子汤对脓毒症致急性胃肠损伤（AGI）患者胃肠功能及炎症因子、氧化应激损伤的影响。,方法,2,将70例脓毒症致AGI患者随机分为治疗组和对照组，每组35例。两组患者均予常规治疗，治疗组加用大黄附子汤，疗程为14 d。疗程结束后评价两组中医临床疗效，并观察两组中医证候积分、胃肠功能指标、氧化应激指标、炎症指标的变化情况。,结果,2,①治疗后，治疗组总有效率为91.4%，对照组总有效率为77.1%；两组临床疗效比较差异有统计学意义（,P,<,0.05）。②治疗后，两组中医证候积分较治疗前均有改善（,P,<,0.05），且治疗组积分低于对照组（,P,<,0.05）。③治疗后，两组腹内压、排便次数较治疗前均有改善（,P,<,0.05），且治疗组优于对照组（,P,<,0.05）。④治疗后，两组AGI分级、APACHEⅡ评分较治疗前均有改善（,P,<,0.05），且治疗组优于对照组（,P,<,0.05）。⑤治疗后两组ROS、MDA水平均较治疗前下降（,P,<,0.05），且治疗组比对照组降低更明显（,P,<,0.05）；治疗后两组SOD水平均较治疗前升高（,P,<,0.05），且治疗组比对照组升高更明显（,P,<,0.05）；治疗后两组TNF-α、IL-6水平均较治疗前降低（,P,<,0.05），且治疗组比对照组降低更明显（,P,<,0.05）。,结论,2,大黄附子汤可恢复脓毒症致AGI患者的胃肠功能，减轻炎症反应及氧化应激损伤，缓解临床症状，提高中医临床疗效。
Abstract
Objective： To observe the effect of Dahuang Fuzi Decoction on gastrointestinal function， inflammatory factors and oxidative stress injury in the patients with acute gastrointestinal injury （AGI） caused by sepsis.,Methods,2,Seventy AGI patients caused by sepsis were randomly divided into treatment group and control group， 35 cases in each group. Both groups were treated with routine treatment，and the treatment group was additionally treated with Dahuang Fuzi Decoction， the treatment course was 14 days. After the treatment， the clinical efficacy of both groups was evaluated，and the changes in TCM syndrome score， gastrointestinal function indexe， inflammatory indexe， oxidative stress indexe were observed.,Results,2,①After treatment， the total effective rate was 91.4% in the treatment group and 77.1% in the control group， the difference in clinical efficacy between the two groups was statistically significant （,P,<,0.05）. ②After treatment，the TCM symptom scores in two groups were both improved compared with those before treatment （,P,<,0.05）， and the scores in the treatment group are lower than those in the control group （,P,<,0.05）. ③After treatment， intra-abdominal pressure and defecation frequency in the two groups were improved compared with those before treatment （,P,<,0.05），and the treatment group was superior than the control group （,P,<,0.05）. ④After treatment， the AGI grade and APACHEⅡ score of the two groups were improved （,P,<,0.05），and the treatment group was superior than the control group. （,P<,0.05）. ⑤After treatment，the levels of ROS and MDA in the two groups were decreased compared with those before treatment （,P<,0.05），and the treatment group decreased more significantly than the control group（,P<,0.05）. After treatment， the level of SOD in the two groups was increased compared with that before treatment，and the treatment group increased more significantly than the control group（,P,<,0.05）. After treatment， the levels of TNF-α and IL-6 in the two groups were decreased compared with those before treatment（,P,<,0.05）， and the treatment group decreased more significantly than the control group（,P,<,0.05）.,Conclusion,2,Dahuang Fuzi Decoction can restore the gastrointestinal function of AGI patients caused by sepsis，reduce inflammatory reaction and oxidative stress injury，alleviate clinical symptoms and improve the clinical curative effect of traditional Chinese medicine.
关键词
脓毒症急性胃肠损伤大黄附子汤氧化应激损伤炎症因子临床研究
Keywords
sepsisacute gastrointestinal injuryDahuang Fuzi Decoctionoxidative stress injuryinflammatory factorsclinical study
references
RHODES A，EVANS L E，ALHAZZANI W，et al. Surviving sepsis campaign： international guidelines for management of sepsis and septic shock： 2016［J］. Crit Care Med， 2017， 45（3）： 486-552.
ROSSAINT J，ZARBOCK A. Pathogenesis of multiple organ failure in sepsis［J］. Crit Rev Immunol， 2015， 35（4）： 277-291.
韩丹，陈乾，施荣，等. 炎调方对脓毒症大鼠肠黏膜屏障及TLR9信号通路影响的实验研究［J］.中国中医急症，2019， 28（11）： 1881-1884， 1892.
刘锦，李慧慧，刘福生.大黄附子汤治疗脓毒症胃肠功能障碍的疗效及安全性的Meta分析［J］.中国中医急症，2020， 29（8）： 1365-1369.
SINGER M，DEUTSCHMAN C S，SEYMOUR C W，et al. The third international consensus definitions for sepsis and septic shock （sepsis-3） ［J］. JAMA， 2016， 315（8）： 801-810.
REINTAM B A，MALBRAIN M L，STARKOPF J，et al. Gastrointestinal function in intensive care patients： terminology，definitions and management， recommendations of the esicm working group on abdominal problems［J］.Intensive Care Med， 2012， 38（3）： 384-394.
李雄辉，张东山.大黄附子汤治疗脓毒症胃肠功能障碍临床研究［J］. 河北中医， 2017， 39（3）： 356-360.
李雅琳，李东风. 脓毒症患者的肠屏障功能损伤变化情况探究［J］. 中国现代医生，2021， 59（9）： 122-124，133.
王慧芳，王方岩，常平，等. 肠道微生态与脓毒症［J］.中华危重症医学杂志（电子版），2018， 11（6）： 415-419.
韦海涛，刘丽，杨国丽，等. 生大黄联合肠内营养对危重症患者胃肠功能的保护作用［J］.中国老年学杂志，2017， 37（24）： 6130-6131.
陈文明，彭圣荔. 大黄附子汤在临床应用及药学分析［J］. 北方药学，2016， 13（5）： 141.
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