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目的:探讨舒腹散敷脐对脓毒症患者胃肠道功能的保护作用。方法:选取广西中医药大学附属瑞康医院脓毒症胃肠功能障碍患者62例,按随机数字表法分组,分别为31例,对照组予以西医常规治疗,治疗组在西医常规治疗基础上予以舒腹散敷脐治疗,两组共治疗14 d为1个疗程,于治疗前后记录胃肠道功能保护相关指标及血液学指标,同时对比不良反应及预后状况。结果:与治疗前相比,两组治疗后腹腔内压力(Intra abdominal pressure,IAP)、胃残留量(gastric residual volume,GRV)、胃肠黏膜p H值(p H value of gastrointestinal mucosa,p Hi)及胃肠减压量降低,治疗后胃动素(motilin,MOT)升高,胃泌素(gastrin,GAS)、肠脂肪酸结合蛋白(Intestinal fatty acid binding protein,IFABP)及二胺氧化酶(diamineoxidase,DAO)水平降低,治疗后血清C反应蛋白(C reactive protein,CRP)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)水平降低,治疗后CD4+、CD8+和Ig G、Ig M水平升高(P<0.05);与对照组相比,治疗组治疗后IAP、GRV、p Hi及胃肠减压量较低,治疗后MOT较高,GAS、IFABP及DAO水平较低,治疗后血清CRP、TNF-α水平较低,治疗后CD4+、CD8+和Ig G、Ig M水平较高(P<0.05);所有患者均获得随访,无病例脱落现象,两组间不良率数据对比,无差异(P>0.05);治疗组MODS发生率41.94%,28 d病死率54.84%,高于对照组(16.13%、29.03%)(P<0.05)。结论:舒腹散敷脐能起到对脓毒症患者胃肠道功能的保护作用,降低炎症指标,提高免疫功能,值得推广。
Objective: To investigate the protective effects of Shufu Sanzhu navel on gastrointestinal function in patients with sepsis. Methods: Sixty-two patients with gastrointestinal dysfunction who were sepsis from Ruikang Hospital of Guangxi University of Traditional Chinese Medicine were selected and divided into three groups according to the random number table method, 31 cases respectively. The control group was given routine western medicine treatment. The treatment group was given conventional treatment based on western medicine Shu belonged to scattered umbilical treatment, two groups of 14 days for a course of treatment, recorded before and after treatment of gastrointestinal function protection related indicators and hematological indicators, while comparing the adverse reactions and prognosis. Results: Compared with those before treatment, intra-abdominal pressure (IAP), gastric residual volume (GRV) and p H value of gastrointestinal mucosa (p Hi) ), Decreased gastrointestinal decompression, elevated motilin (MOT), increased gastrin (GAS), intestinal intestinal protein, IFABP and diamine oxidase diamineoxidase and DAO, the level of serum C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) decreased after treatment, the levels of CD4 +, CD8 +, IgG and IgM (P <0.05). Compared with the control group, the IAP, GRV, p Hi and the amount of gastrointestinal decompression in the treatment group were lower, the MOT was higher, the levels of GAS, IFABP and DAO were lower after treatment, CRP and TNF-α levels were lower, CD4 +, CD8 +, IgG and IgM levels were higher after treatment (all P <0.05); All patients were followed up without any cases of exfoliation. There was no difference between the two groups (P> 0.05). The incidence of MODS in treatment group was 41.94%, and the mortality rate in 28 days was 54.84%, higher than that in control group (16.13%, 29.03%) (P <0.05). Conclusion: Shu-belly scattered navel can play a protective effect on gastrointestinal function in patients with sepsis, reduce inflammation indicators, improve immune function, it is worth promoting.