大黄治疗重度有机磷农药中毒后多器官功能障碍综合征的临床研究

目的 研究大黄在防治重度急性有机磷中毒（AOPP）引起全身炎症反应综合征（SRIS）、胃肠功能障碍、多器官功能障碍综合征（MODS）方面的效果.方法 将100例受试对象按照随机对照原则分为大黄组50例和甘露醇组50例.2组均采用留置胃管反复洗胃,长托宁、氯解磷定肌注,综合对症治疗.在此基础上,大黄组予生大黄粉12.0g胃管注入,每8h 1次;甘露醇组予甘露醇250mL胃管注入,每12h 1次.均连续使用5d.统计2组患者入院时及病程的1,2,3,4,5d处于胃肠功能障碍、MODS状态的病例数以及血C反应蛋白（CRP）的浓度.结果 在病程的2,3,4,5d,大黄组血CRP浓度的降幅较甘露醇组显著（P均〈0.05）;胃肠功能障碍的改善快于甘露醇组,在病程的1,2,3d 2组比较有显著性差异（P均〈0.05）;第2,3,4,5天,大黄组MODS发生例数减少速度快于甘露醇组（P均〈0.05）.结论 大黄治疗AOPP患者能促进胃肠功能恢复,抑制CRP的释放,提升MODS防治效果.

Study on rhubarb in multiple organ dysfunction syndrome after acute organophosphorus pesticide poisoning

Objective It is to investigate the effect of rhubarb in prevention and cure of systemic inflammatory response syndrome （SIRS） , gastrointestinal dysfunction, multiple organ dysfunction syndrome （MODS） in patients with acute organophosphorus pesticide poisoning （AOPP）. Methods One hundred patients with AOPP were randomly divided into two groups： 50 cases of rhubarb group and 50 cases of mannitol group. Two groups were both treated as gastric lavage repeatedly with indwelling catheters, pyraloxime chloride and penehyclidine hydrochloride intramuscular injection, and general symptomatic treatment. The same basic treatment above was given, 12.0 g Rhubarb tube injection for rhubarb group, every eight hours once for consecutive 5 days; 250 mL mannitol tube injection for mannitol group, twice a day with an interval of 12 hours for consecutive 5 days. The number of cases with gastrointestinal dysfunction, multiple organ dysfunction syndrome were calculated and the levels of blood C -reactive protein （CRP） was observed in both groups on admission, 1, 2, 3, 4 and 5 days during treatment. Results On 2, 3, 4 and 5 days during treatment, the fall of blood CRP levels in rhubarb group was faster than that in mannitol group （ all P 〈 0.05 ）. The improvement of gastrointestinal dysfunction in rhubarb group was faster than that in mannitol group, there were significant difference on 1, 2 and 3 days during treatment between two groups （ all P 〈 0.05 ） ; On 2, 3, 4 and 5 days, the number of MODS cases of rhubarb group was reduced faster than that of mannitol group （ all P 〈 0. 05 ）. Conclusion In treatment of patients with AOPP, Rhubarb can promote the recovery of gastrointestinal function, inhibit the release of CRP, and enhance the control effect of MODS.