肠胃舒联合常规疗法治疗脓毒症胃肠功能障碍临床疗效观察

【目的】观察肠胃舒联合西医常规疗法治疗脓毒症胃肠功能障碍患者的临床疗效。【方法】将120例脓毒症胃肠功能障碍患者随机分为治疗组和对照组各60例。对照组给予西医常规疗法治疗,治疗组给予肠胃舒联合西医常规疗法治疗,7 d后比较2组患者治疗前后白细胞计数(WBC)、降钙素原(PCT)、腹腔内压力(IAP)、肠功能障碍评分、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分的变化情况,评价2组临床疗效及安全性。【结果】1治疗过程中,治疗组脱落1例,剔除1例,最终纳入统计病例58例;对照组脱落4例,剔除2例,最终纳入统计病例54例。2治疗后,治疗组的总有效率为91.38%,对照组为88.89%,治疗组疗效优于对照组(P0.05)。3治疗后,2组患者的WBC、PCT等炎症指标及IAP均较治疗前明显改善(P0.01),且治疗组的改善作用均优于对照组(P0.01)。4治疗后,2组患者的肠功能障碍评分、APACHEⅡ评分均明显低于治疗前(P0.01),且治疗组的降低作用均优于对照组(P0.01)。5试验过程中,治疗组有4例出现恶心,对照组有5例出现恶心、腹胀,均未作处理,1周后症状自行消失;2组患者的肝、肾功能均未见明显异常。【结论】肠胃舒可减轻脓毒症胃肠功能障碍患者的炎症反应,改善胃肠功能障碍,并能减轻患者的病情严重程度。

Clinical Observation of Changwei Shu Combined with Conventional Western Medicine Therapy in Treating Sepsis Patients with Gastrointestinal Dysfunction

Objective To observe the clinical curative effects of Changwei Shu combined with conventional western medicine therapy in treating the sepsis patients with gastrointestinal dysfunction.Methods A total of 120 cases of sepsis patients with gastrointestinal dysfunction were randomly divided into treatment group and control group,60 patients in each group.The control group was given conventional western medicine therapy,and the treatment group was given Changwei Shu combined with conventional western medicine therapy.After treatment for 7 days,the clinical efficacy and safety were evaluated by observing the changes in white blood cell (WBC) count,procalcitonin (PCT) level,intra-abdominal pressure (IAP),gastrointestinal dysfunction scores,and scores of acute physiology and chronic health evaluation (APACHE Ⅱ).Results (1) For one case dropped out and one was excluded from the treatment group,and 4 cases dropped out and 2 were excluded from the control group,a total of 58 cases in the treatment group and 54 in the control group were included into the study at the end of the trial.(2) The total effective rate of the treatment group was 91.38％ and that of the control group was 88.89％,the difference being significant (P ＜ 0.05).(3) After treatment,WBC count,PCT level and IAP of the two groups were improved (P ＜ 0.01 compared with those before treatment),and the improvement of the treatment group was superior to that of the control group (P ＜ 0.01).(4) After treatment,gastrointestinal dysfunction scores and APACHE Ⅱ scores of the two groups were decreased(P ＜ 0.01 compared with those before treatment),and the decrease of the treatment group was superior to that of the control group (P ＜ 0.01).(5) During the treatment,4 cases from the treatment group had nausea,and 5 cases from the control group had nausea and abdominal distention,and the symptoms disappeared spontaneously one week later.No obvious changes were found in the hepatic and renal function of the two groups.Conclusion Changwei Shu exerts an effect on reducing the inflammation,improving the gastrointestinal function,and relieving the illness severity of sepsis patients with gastrointestinal dysfunction.