大黄对危重病患者多器官功能衰竭综合征的防治研究

目的　研究大黄对危重病患者MODS的防治效果。方法　 10 90例ICU患者 ,研究对象的入选标准是严重创伤、休克、感染、外科急腹症、化学和物理因素损伤等所致脓毒症。 6 37例患者列入大黄预防治疗组 ,非大黄预防治疗组 4 5 3例。观察两组患者应激性溃疡、中毒性肠麻痹和MODS的发生率。结果　大黄预防组 6 37例患者中 ,并发应激性溃疡出血 5 7例 ,中毒性肠麻痹 4 3例 ,MODS 5 8例 ;而非大黄预防治疗组中 ,并发应激性溃疡出血 86例 ,中毒性肠麻痹 91例 ,MODS 95例 ,两组间有显著的统计学差异 (P<0 0 0 5 ) ;大黄预防组中 337例进行肠内营养 ,并发MODS 15例 ;而非大黄预防组中 178例进行肠内营养 ,并发MODS 2 3例 ,两组间有显著差异 (P <0 0 0 5 )。大黄预防组中肠内配合肠外营养 179例 ,并发MODS 10例、肠外营养 98例 ,并发MODS 15例 ;而非大黄预防组中肠内配合肠外营养 12 7例 ,并发MODS 19例、肠外营养 117例 ,并发MODS 32例 ,大黄预防组和非预防组间有显著差异 (P <0 0 5 )。肠外营养患者MODS的发生率高于肠内营养和肠内配合肠外营养的患者 (P <0 0 5 ) ;无营养支持的患者MODS的发生率最高。治疗研究显示累及四个以上脏器MODS患者中 ,伴胃肠功能衰竭患者经大黄治疗后其存活率达 5 2 6 % ,显著高于非

Therapeutical and preventive effects of Rhubarb on multiple organ dysfunction syndrome in critical illness

Objective To study the therapeutical and preventive effects of Rhubarb on multiple organ dysfunction syndrome (MODS). Methods One thousand and ninty patients, who suffered from sepsis caused by trauma, shock and infection, were enrolled in this study.The patients were divided into two groups, 637 cases in preventive treatment group and 453 cases in non-preventive treatment group. The incidence of stress ulcer, toxic ileus and MODS was observed in the two groups. Results The incidence of stress ulcer, toxic ileus and MODS in preventive Rhubarb treatment group was lower than that in non-preventive Rhubarb treatment group. There was significant difference between two groups (P<0.005). Furthermore, the routine of nutrition support also affected the incidence of MODS, which was higher in parenteral nutrition compared to that in enteral nutrition and enteral combined parenteral nutrition (P<0.05).Therapeutical study revealed that the survival rate in the MODS patients, in which more than four organs were involved, was much higher in Rhubarb treatment group than that in non-Rhubarb treatment group (P<0.025).Conclusion Rhubarb has a preventive effect on MODS in critical illness, and also obviously improves the survival rate of MODS patients. Its pharmaceutical effects may function through gastrointestinal mechanisms.