大黄脐贴治疗脓毒症胃肠功能障碍临床研究

目的:探究中药大黄脐贴治疗脓毒症胃肠功能障碍的效果与作用机制。方法:将110例脓毒症胃肠功能障碍患者按照治疗顺序随机分为对照组和观察组,每组各55例。对照组患者予开塞露治疗,观察组患者予中药大黄脐贴治疗。观察两组患者胃肠功能评分以及肠鸣音改善情况,比较两组患者血清白细胞介素-10(IL-10)、白细胞介素-17A(IL-17A)、Treg/Th₁₇水平。结果:治疗后,两组患者各项便秘评分、肠功能评分均低于治疗前,且观察组评分低于对照组(均P<0.05)。观察组肠鸣音总改善率较对照组高,差异有统计学意义(P<0.05)。治疗后,观察组IL-10水平高于对照组,IL-17A水平较对照组低,差异有统计学意义(均P<0.05)。治疗后,观察组Treg/Th₁₇水平显著高于对照组(P<0.05)。结论:中药大黄脐贴治疗脓毒症胃肠功能障碍疗效显著,可明显改善患者肠胃功能,其机制可能与调控机体Treg/Th₁₇平衡相关。

Clinical observation of rhubarb umbilical patch in the treatment of gastrointestinal dysfunction in sepsis

Objective:To explore the effect and mechanism of rhubarb umbilical patch in the treatment of gastrointestinal dysfunction in patients with sepsis.Methods:A total of 110 patients with septic gastrointestinal dysfunction were randomly divided into control group and observation group,55 cases in each group.Patients in the control group were treated with cerulosum,while patients in the observation group were treated with rhubarb umbilical patch.The scores of gastrointestinal function and the improvement of bowel sounds were observed,and the levels of serum interleukin-10(IL-10),interleukin-17A(IL-17A)and Treg/Th₁₇ were compared between the two groups.Results:After treatment,the scores of constipation and intestinal dysfunction in the two groups were lower than before treatment,and the observation group was lower than the control group(all P<0.05).The total improvement rate of bowel sounds in the observation group was higher than that in the control group(P<0.05).After treatment,the level of IL-10 in the observation group was significantly higher than that in the control group,and the level of IL-17A was significantly lower than that in the control group(all P<0.05).After treatment,Treg/Th₁₇ levels in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Rhubarb umbilical patch with traditional Chinese medicine is effective in the treatment of gastrointestinal dysfunction in sepsis,which can improve gastrointestinal dysfunction in patients.The mechanism may be related to the regulation of Treg/Th₁₇ balance in the body.