通腑净化汤对多脏器功能障碍综合征患者胃肠功能的影响

目的:探讨通腑净化汤改善创伤所致多脏器功能障碍综合征(MODS)病人胃肠道功能的机制。方法:60例患者随机分为给药组(30例)和对照组(30例)。给药组采用通腑净化汤和常规治疗,对照组仅采用常规治疗。通过检测血二胺氧化酶(DAO)、血D-乳酸、尿乳果糖/甘露醇(L/M)比值了解肠黏膜受损情况;通过测定腹内压(膀胱内压)及疗效评价采用我国多器官功能障碍综合征病情严重程度评分系统评分了解胃肠道的运动能力。结果:治疗10d后,给药组血DAO(3.93±0.40)较对照组(5.87±0.38)减少;给药组血D-乳酸(2.46±0.66)较对照组(5.96±0.32)减少;尿L/M给药组(0.0295±0.037)较对照组(0.0688±0.0453)减少;且以上均有统计学意义。第10天腹内压给药组(13.49±2.69)较对照组(16.30±2.37)降低;疗效评价给药组0分人数(29例)较对照组(17例)增多;亦都有统计学意义。结论:通腑净化汤可提高创伤后胃肠道黏膜的屏障保护功能,减少肠黏膜的损伤,促进肠蠕动。

Effect of Tongfu Purification Decoction on Gastrointestinal Function in Patients with Multiple Organ Dysfunction Syndrome

Objective：To investigate the effect of Tongfu Purification Decoction on the gastrointestinal function in patients with multiple organ dysfunction syndrome （MODS） caused by trauma. Methods-60 patients were randomly divided into treatment group （30 cases）and control group（ 30 cases）. Treatment group was given Tongfu Purification Decoction and conventional treatment and the control group was only given conventional therapy. During treatment, by detecting blood diamine oxidase （DAO） , D - lactic acid ,urinary lactulose/mannitol （L/M） ratio to understand the damage to the intestinal mueosa. By measuring the intra - abdomi- nal pressure （pressure within the bladder） and treatment evaluation using our multiple organ dysfunction syndrome severity sco- ring system to understand the gastrointestinal tract athletic ability. Results：After treated 10 d, the levels of serum DAO in the treat- ment group （3. 93±0. 40） was lower than that of the control group （5. 87±0. 38）. The D -Lactic acid level of treatment group （2.46 ± 0. 66） was lower than that of the control group （5.96 ± 0. 32）. And the levels of urinary L/M in the treatment group （0. 0295±0. 037） was lower than that of the control group （0. 0688 -±0. 0453）. All of them had statistical significance. On the 10th day,the intra- abdominal pressure in the treatment group （13.49 ± 2. 69） was lower than that of the control group （16. 30 ±2. 37） and the efficacy evaluation on treatment group 0 number （29 cases） was more than that of the control group （ 17 ca- ses）. Conclusion：Tongfu Purification Decoction can improve post -traumatic gastrointestinal mucosa barrier protection,reduce in- testinal damage and promote peristalsis.