直肠滴入通腑理肺汤对严重脓毒症、多器官功能障碍综合征患者胃肠功能的调节作用及其可能机制

目的研究直肠滴入通腑理肺汤对严重脓毒症/多器官功能障碍综合征患者胃肠功能调节作用及其可能的机制。方法选择我院2010年5月-2012年5月的严重脓毒血症患者68例,随机分为通腑理肺汤组和对照组各34例,两组患者均接受常规内科治疗,通腑理肺汤组在上述基础上给予直肠缓慢滴入通腑理肺汤;对照组给予每日等量生理盐水直肠滴入,两组均接受2次/d治疗。治疗3d、7d时观察两组临床症状、中医证候学积分、C反应蛋白水平、胃液pH值、胃排空试验腹内压力、健康状况评分系统、MODS病情严重程度评分变化并行胃肠功能障碍疗效评价。结果通腑理肺汤患者临床症状较对照组改善明显,两组治疗后中医证候学积分均降低,治疗7d同对照组比较差异有统计学意义;胃肠功能障碍疗效评分高于对照组;两组血清CRP、胃排空试验、腹腔内压力、MODS病情严重程度评分均明显降低,胃液pH值明显升高,通腑理肺汤组指标改善程度明显好于对照组。结论通腑理肺汤直肠滴入可有效改善严重脓毒症/MODS患者临床症状,显著降低中医改善级调节胃肠功能,提高胃液pH值,改善调节胃肠功能,提高治疗严重脓毒症效率,其机制可能同降低血CRP水平、炎症反应及腹腔内压力有关。

Aclinical research on regulation of gastrointestinal function by ectal instillation of tongfu lifei soup patients with severe sepsis or multiple organ dysfunction syndrome

Objective To study the rectum dropping through experiments of tongfu lifei soup to severe sepsis or multiple organ dysfunction syndrome patients with gastrointestinal function mechanism and its possible mechanism.Methods Choose from May 2010 to May 2012 were 68 cases of patients with severe sepsis,in strict accordance with the random grouping principle is divided into through experiments of tongfu lifei soup group 34 cases and control the 34 patients,two groups of patients to accept conventional medical treatment,through experiments of tongfu soup group in the above basis to rectal slow drip into the through experiments of tongfu soup;Control group give daily equivalent physiological saline rectal dropping,two groups are accept 2 times daily treatment.Treatment of 3d,7d observation two groups of clinical symptoms and the doctor of traditional Chinese medicine syndrome learn integral,c-reactive protein level,gastric pH value,gastric emptying test intra-abdominal pressure,level health rating system,MODS illness severity score changes parallel gastrointestinal dysfunction curative effect evaluation.Results Through experiments of tongfu soup,the clinical symptoms improved than control group,the two groups after treatment of traditional Chinese medical syndrome of learning integral are lower,compared with 7d treatment there is a significant difference statistically significant;Gastrointestinal dysfunction curative effect score higher than those in the control group;Two groups of serum CRP on admission gastric emptying test,intra-abdominal pressure,MODS illness severity score were significantly lower,gastric pH value increased significantly,through experiments of tong fu soup group index to improve significantly better than the control group;Conclusion Through experiments of tongfu soup rectal dropping can effectively improve the severe sepsis/MODS patients clinical symptoms and reduce the doctor of traditional Chinese medicine to improve level regulating gastrointestinal function,improve gastric PH value,improve the regulating gastrointestinal function,significantly improve the treatment of severe sepsis,whose mechanism is probably with reduced blood CRP level,inflammatory reaction and intra-abdominal pressure relevant.