防治抗生素相关性腹泻不可忽视血瘀证

目的:研究血瘀证对抗生素相关性腹泻(Antibiotic-Associated Diarrhea,AAD)发病率的影响及其在AAD证型分布中所占比例。方法:对2012年2月至2013年2月在我院ICU病房接受抗生素治疗的216例病例进行回顾性调查,研究血瘀证、非血瘀证患者接受抗生素治疗后AAD的发病率;血瘀证在AAD证型分布中所占的比例;引发AAD合并血瘀证的病理机制。结果:血瘀证患者接受抗生素治疗后AAD发病率45.26%非血瘀证者31.67%,P0.05;其中,脾气亏虚患者合并血瘀证者发生AAD几率58.33%非血瘀证者12.50%,P0.05;湿浊内阻患者合并血瘀证者发生AAD几率62.50%非血瘀证者19.23%,P0.05;脾虚湿浊患者合并血瘀证者发生AAD几率75.00%非血瘀证者27.27%,P0.05。在AAD证型分布中,血瘀证比例为29.63%,仅次于脾虚痰湿证64.20%居第二。在导致AAD合并血瘀证的病理机制中,痰饮瘀血互化占54.17%。结论:血瘀证、特别是脾虚湿阻型患者在合并血瘀证时更易发生AAD;血瘀证是AAD证型分布中的重要组成部分,其地位仅次于脾虚痰湿证;在多数情况下,导致AAD合并血瘀证的病理机制是痰饮瘀血互化。

Attentions to Blood Stasis Syndrome when Preventing and Treating Antibiotic-associated Diarrhea

Objective： To study the effect of blood stasis syndrome on the onset rate of AAD. Methods： Retrospective study was con- ducted on the 216 patients admitted to ICU in our hospital from 2012 February to 2013 February and treated with antibiotics, in the as- pects of onset rate of AAD on patients with and without blood stasis syndrome, the percentage AAD was taking among the syndrome pat- terns of AAD, as well as the mechanism of AAD complicated with blood syndrome. Results ： The onset rate of AAD on blood stasis pa- tients treated by antibiotics was 45.26% , which was higher than that of the non-blood stasis patients （ P 〈 0.05 ）. Among all the syn- drome patterns of AAD, blood stasis took 29.63%, which was after the spleen deficiency accompanying phlegm. Among the pathological causes of AAD complicated with blood stasis, the phlegm and blood stasis took the percentage of 54.17%. Conclusion： Patients with blood stasis especially complicated with spleen deficiency are more easily to get AAD. Blood stasis is the most important syndrome in AAD syndrome patterns. The pathological mechanism of AAD accompanying with blood stasis is phlegm and blood stasis.