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目的观察清营汤加味对老年脓毒症患者胃肠道功能的保护作用。方法将62例患者随机分成治疗组与对照组,每组31例。两组均采用西医常规治疗,治疗组加用清营汤加味方内服。两组疗程均为7天,观察急性生理学及慢性健康状况评分(APACHEⅡ)、血红素加氧酶-1(HO-1)、降钙素原(PCT)水平以及腹内压(IAP)、胃肠减压量、胃肠黏膜pH值(pHi)的变化情况,并记录胃肠道开通时间、MODS的发生率及随访28天死亡率。结果①组间治疗后比较,APACHEⅡ评分、HO-1及PCT水平下降幅度治疗组明显大于对照组(P<0.05)。②组间治疗后比较,IAP、胃肠减压量及pHi水平下降程度治疗组明显大于对照组(P<0.05)。③两组胃肠道开通时间、MODS发生率及28天死亡率比较,差异均有统计学意义,治疗组预后明显优于对照组(P<0.05)。结论清营汤加味联合西医常规疗法治疗老年脓毒症患者,可较好抑制炎症反应,并能启动机体胃肠道保护系统,从而缩短开通胃肠道的时间,进而减少MODS的发生。
Objective To observe the protective effect of Qingying Decoction on gastrointestinal function in senile sepsis patients. Methods 62 patients were randomly divided into treatment group and control group, 31 cases in each group. Both groups were treated with conventional Western medicine, the treatment group plus Qingying Decoction oral administration. The two groups were treated for 7 days. APACHEⅡ, HO-1, PCT and IAP, Intestine decompression volume and pH value of gastrointestinal mucosa, and recorded the opening of gastrointestinal tract, the incidence of MODS and the 28-day mortality rate. Results ① After treatment, APACHEⅡscore, HO-1 and PCT decreased significantly in treatment group than in control group (P <0.05). ② After treatment, IAP, the amount of gastrointestinal decompression and the level of pHi decreased significantly in the treatment group than in the control group (P <0.05). ③ The two groups of gastrointestinal opening time, MODS incidence and 28-day mortality rates, the difference was statistically significant, the treatment group was significantly better than the control group (P <0.05). Conclusion Qingying decoction combined with Western conventional therapy in elderly patients with sepsis can inhibit the inflammatory response, and can start the body’s gastrointestinal protection system, thereby shortening the opening of the gastrointestinal tract, and thus reduce the incidence of MODS.