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经穴应用四逆汤治疗脓毒症胃肠功能障碍患者的临床研究。

Application of Sini Decoction at acupoint on gastrointestinal dysfunction in patients with sepsis: A clinical study.

机构信息

Department of Emergency Medicine, Hangzhou Third People's Hospital, Hangzhou, Zhejiang Province, PR China.

出版信息

Medicine (Baltimore). 2024 Nov 1;103(44):e40464. doi: 10.1097/MD.0000000000040464.

Abstract

The occurrence of gastrointestinal dysfunction is widely recognized as a prevalent complication in patients with sepsis. To investigate clinical effect of Sini Decoction at acupoint on gastrointestinal dysfunction in sepsis patients. Seventy-five patients with gastrointestinal dysfunction caused by sepsis were randomly divided into 2 groups. Treatment group received routine Western medicine treatment combined with Sini Decoction at acupoint, while control group treated with talcum powder at acupoint. Treatments in both groups lasted 7 days. Changes in the acute physiology and chronic health evaluation II score, sequential organ failure assessment score, mechanical ventilation duration, the length of Intensive Care Unit (ICU) stay, enteral nutrition tolerance scores, abdominal circumference, gastric residual volume, bowel sounds, and serum index were observed. After treatment, the enteral nutrition tolerance score, abdominal circumference, gastric residual volume, and levels of lactate and interleukin-6 were significantly lower in the treatment group compared to the control group. Bowel sounds were more active and motilin levels were higher in the treatment group. Additionally, the length of ICU stay was significantly shorter in the treatment group than in the control group. Our findings demonstrated that the application of Sini Decoction at acupoints in sepsis patients with gastrointestinal dysfunction can effectively enhance gastrointestinal function, leading to a reduction in ICU stay duration and an improvement in patients' prognosis.

摘要

胃肠功能障碍的发生被广泛认为是脓毒症患者的一种普遍并发症。本研究旨在探讨经穴四逆汤治疗脓毒症胃肠功能障碍的临床疗效。将 75 例脓毒症胃肠功能障碍患者随机分为 2 组,治疗组在常规西医治疗的基础上加用经穴四逆汤治疗,对照组给予经穴滑石粉治疗,2 组疗程均为 7 d。观察 2 组患者急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评分、序贯器官衰竭评分(SOFA)、机械通气时间、重症监护病房(ICU)住院时间、肠内营养耐受评分、腹围、胃残留量、肠鸣音及血清学指标的变化。治疗后,治疗组患者肠内营养耐受评分、腹围、胃残留量、血乳酸和白细胞介素-6(IL-6)水平均明显低于对照组,肠鸣音更加活跃,胃动素水平更高,ICU 住院时间明显短于对照组。结果表明,经穴四逆汤治疗脓毒症胃肠功能障碍患者能有效增强胃肠功能,缩短 ICU 住院时间,改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ad/11537635/8dcedda22c26/medi-103-e40464-g001.jpg

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