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目的:观察新加黄龙汤对脓毒症休克患者胃肠道功能的保护。方法:选取120例患者按随机数字表法随机分为4组,新加黄龙汤组予常规西医治疗基础上加用新加黄龙汤;调胃承气汤组予常规西医治疗基础上加用调胃承气汤;小承气汤组予常规西医治疗基础上加用小承气汤;常规组予常规西医治疗。治疗7 d后,比较治疗前后4组患者出现的胃肠功能障碍的临床例数、中医证候积分、胃肠功能障碍评分、CRP、PCT、内毒素水平及肠通透性。结果:治疗前4组患者胃肠功能障碍的临床例数、中医证候积分、胃肠功能障碍评分、CRP、PCT、内毒素水平及肠通透性等比较差异无统计学意义;治疗后小承气组、调胃承气组及新加黄龙汤组D-乳酸、L/M及DAO水平较治疗前下降,新加黄龙汤组下降更为明显,常规组治疗前后差异无统计学意义;治疗后4组患者CRP、PCT及内毒素水平均下降,新加黄龙汤组较其余三组下降更明显,小承气组、调胃承气组及常规组组间比较差异无统计学意义;治疗后新加黄龙汤组、小承气组、调胃承气组出现胃肠功能障碍的临床例数及百分比下降,新加黄龙汤组下降更明显,而常规组治疗前后差异无统计学意义;治疗后,小承气组、调胃承气组及新加黄龙汤组腹部症状、肠鸣音明显改善,便次增多,中医证候积分亦有明显改善,但组间差异无意义,而常规组治疗前后差异无统计学意义;治疗后4组患者胃肠功能障碍评分均较治疗前降低,且新加黄龙汤组降低更明显。结论:新加黄龙汤对脓毒症休克患者胃肠道功能具有良好的保护作用。
Objective: To observe the protective effect of Xinhuang Huanglong Decoction on gastrointestinal function in septic shock patients. Methods: One hundred and twenty patients were randomly divided into four groups according to the random number table method. The newly added Huanglongtang group was added with Huanglongtang on the basis of conventional western medicine. The Tiaocheng Chengqi soup group was treated with conventional western medicine Stomach Chengqi Tang; Xiao Cheng Qi Tang group to conventional Western medicine plus Xiao Cheng Qi Tang; conventional group to conventional Western medicine treatment. After 7 days of treatment, clinical symptoms, TCM syndrome scores, gastrointestinal dysfunction scores, CRP, PCT, endotoxin levels and intestinal permeability were compared among the four groups before and after treatment. Results: There was no significant difference in clinical symptoms, TCM syndrome score, gastrointestinal dysfunction score, CRP, PCT, endotoxin levels and intestinal permeability among the four groups before treatment. The levels of D-lactate, L / M and DAO in Chengqi group, Tiaowei Chengqi group and Xinjianhuanglongtang group were lower than those before treatment, and the decrease was more obvious in Huanglongtang group. The difference was not statistically significant in the conventional group before and after treatment. After treatment, the CRP, PCT and endotoxin levels of four groups of patients decreased. The new Huanglongtang decoction decreased more obviously than the other three groups. There was no significant difference between Xiaochengqi group, Tiaowei Chengqi group and conventional group. After treatment, the newly-added Huanglongtang group, Xiaochengqi group and Tiawei Chengqi group had decreased clinical scores and percentages of gastrointestinal dysfunction, the new Huanglongtang decoction decreased more obviously, but there was no significant difference between the two groups ; After treatment, Xiaochengqi group, Tiaowei Chengqi group and Xinhuanglonglongtang group showed significant improvement in bowel symptoms, bowel sounds and increased TCM syndrome scores, but there was no significant difference between groups The difference between the conventional group before and after treatment was not statistically significant; after treatment, 4 groups of patients Gastrointestinal dysfunction scores were lower than before treatment, and the new Huanglong Decoction decreased more significantly. Conclusion: New Huanglong Decoction has a good protective effect on gastrointestinal function in septic shock patients.