摘要
目的:观察急下存阴法治疗脓毒症急性胃肠损伤的胃肠动力临床疗效。方法:脓毒症急性胃肠损伤少阴三急下证患者66例随机分为对照组和试验组各33例。对照组给予常规西医治疗;试验组在对照组的治疗基础上加予急下存阴中药汤剂。测定两组患者AGI分级、GIF评分、APACHEⅡ评分、SOFA评分、中医证候积分、腹胀症状积分、便秘症状积分、口燥咽干症状积分、血清胃泌素(gastrin,GAS)、腹内压(intra-abdominal pressure,IAP)、肠鸣音分级、腹壁张力。结果:治疗前后,AGI分级、GIF评分、SOFA评分、中医证候积分、腹胀症状积分、便秘症状积分、口燥咽干症状积分、IAP、肠鸣音分级、腹壁张力测定,试验组较对照组均有所降低(P<0.05),血清GAS试验组较对照组均有所上升(P<0.05),差异有统计学意义。APACHEⅡ评分在试验组治疗后降低,但组间差异不明显,以待进一步扩大研究。结论:研究结果显示,急下存阴法治疗能够减轻脓毒症胃肠功能障碍,促进胃肠动力,改善脓毒症急性胃肠损伤的预后。
Objective:To observe the clinical curative effect of applying timely purgation to preserve Yin method on acute gastrointestinal motility in the treatment of acute gastrointestinal injury in sepsis.Methods:Sixty-six patients with acute gastrointestinal injury of sepsis were randomly divided into a controlled group and an experimental group with 33 cases in each group.The treatment of the controlled group followed the 2016 International Guidelines for the Management of Sepsis and Septic Shock and 2012 Guidelines for the Definition and Management of Acute Gastrointestinal Injury to receive conventional western medicine while the experimental group was given timely purgation to preserve Yin TCM decoction based on the treatment of the controlled group.AGI grade,GIF score,APACHEⅡscore,SOFA score,TCM syndrome score,abdominal distension score,constipation symptom score,dry mouth and dry throat symptom score,serum gastrin(GAS),intra-abdominal pressure(IAP),Bowel sounds classification and abdominal wall tension were measured for the two groups of patients.Results:Before and after the treatment,among AGI classification,GIF score,SOFA score,TCM syndrome score,abdominal distension score,constipation symptom score,dry mouth and throat symptom score,IAP,bowel sound classification,abdominal wall tension measurement,the test group was better than the controlled group.There was a decrease(P<0.05),and the serum GAS test group had an increase compared with the controlled group(P<0.05),and the difference was statistically significant.The APACHEⅡscore decreased after treatment in the experimental group,but the difference between the groups was not significant,pending further expansion of the study.Conclusion:The results of the study show that the the TCM cure of timely purgation to preserve Yin can reduce gastrointestinal dysfunction in sepsis,promote gastrointestinal motility,and improve the prognosis of acute gastrointestinal injury in sepsis.
作者
吴歆頔
钱风华
李璟
赵雷
严理
沈梦雯
丁纯蕾
钱义明
WU Xindi;QIAN Fenghua;LI Jing(Yueyang Clinical Medical College,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of Emergency Medicine,Yueyang Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;不详)
出处
《四川中医》
2022年第7期77-80,共4页
Journal of Sichuan of Traditional Chinese Medicine
基金
多学科联合干预危重症患者急性胃肠损伤诊疗模式探讨(ZY(2018~2020)-FWTX-6012)
中医重点专科培育项目(中医急诊科)
关键词
脓毒症
急性胃肠损伤
急下存阴法
胃肠动力
Sepsis
Acute gastrointestinal injury
Acute downward negative storage method
Gastrointestinal motility
作者简介
吴歆頔,博士在读,E-mail:cindywu1111@126.com;通讯作者:钱义明,博士,主任医师,教授,硕士生导师,Email:qianym2004@163.com。
