目的 中西医结合治疗老年脓毒症继发急性胃肠功能损伤患者的临床观察.方法40例患者分为治疗组和对照组各20例.对照组予以抗感染、液体复苏、降糖、肠内营养支持等常规治疗.治疗组在对照组治疗基础上加服益气通腑方.观察两组治疗前后中医证候改善、器官功能评分、白细胞、超敏C反应蛋白、肠型脂肪酸结合蛋白、二胺氧化酶、肠三叶因子水平变化情况.结果 治疗5 d后,研究组中医证候总有效率90.00%高于对照组的50.00%(P<0.01);两组中医证候改善,器官功能评分(SOFA评分及APACHEⅡ评分)、血浆白细胞、超敏C反应蛋白、肠型脂肪酸结合蛋白、二胺氧化酶、肠三叶因子水平均较治疗前降低(均P<0.05或P<0.01),且治疗组各项指标改善均优于对照组(均P<0.05).结论 益气通腑方合西药治疗治疗脾胃气虚,肠燥热结证的急性胃肠功能损伤脓毒症老年患者疗效优于单纯西医治疗.%Objective: To observe the clinical effect of traditional Chinese and Western medicine on acute gas-trointestinal function injury secondary to sepsis. Methods: 40 sepsis patients with acute gastrointestinal function injury of deficiency of spleen-Qi and stomach-Qi and intestinal heat syndrome were divided into the treatment group(n=20)and the control group(n=20)randomly,and both received medical treatment,such as anti-infec-tion,liquid resuscitation,hypoglycemic,enteral nutrition support and so on. The treatment group were orally given Yiqi Tongfu Decoction additionally. The improvement of TCM symptoms,organ function score,white blood cell, hypersensitive c-reactive protein,intestinal fatty acid binding protein,diamine oxidase,and intestinal trifoliator factor in the two groups before and after treatment were observed. Results: After 5-day medical treatment,TCM symptom improvement,organ function score,white blood cell,hypersensitive c-reactive protein,intestinal fatty acid binding protein,diamine oxidase,and intestinal trifoliator factor in the two groups were obviously declined com-pared with those before the treatment(P<0.05),and the declining rate of the treatment group was much higher than that of the control group(P<0.05). Conclusion: Y iqi Tongfu Decoction combined with Western medicine has a better effect than only Western medicine on sepsis patients with acute gastrointestinal function injury of de-ficiency of spleen-Qi and stomach-Qi and intestinal heat syndrome.
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