余应嘉,叶淑芳,杨天化,毕伟彬,欧阳勇
YU Yingjia,YE Shufang,YANG Tianhua,BI Weibin,OUYANG Yong

• 1:广州市中西医结合医院药学部
• 2:广州市中西医结合医院重症医学科

摘要(Abstract)：

目的研究五子散热敷包对严重脓毒症患者胃肠功能及血清胃泌素的影响并探讨其作用机制。方法选择某院重症医学科收治的60例诊断为脓毒症的患者,随机分为对照组和治疗组各30例。治疗组在治疗基础上使用五子散热敷包对脐周进行热敷,对照组患者予以热水袋进行同样操作。于治疗前、治疗3 d及治疗7 d观察各组患者临床症状、胃残留量、膀胱压、血清胃泌素(GAS)水平及急性生理学与慢性健康状况评分系统II(APACHE II)评分的相关变化。结果治疗组临床胃肠道临床疗效总有效率(73.3%)优于对照组(50.0%),差异有统计学意义(P<0.05);治疗组患者每日排便次数、肠鸣音恢复时间较对照组减少,差异有统计学意义(P<0.05),且肠内营养摄入量比对照组改善明显,差异有统计学意义(P<0.01);两组患者治疗3 d后胃残留量、膀胱压、GAS及APACHE II评分均有所下降,治疗7 d后治疗组在以上指标的改善程度优于对照组,差异有统计学意义(P<0.01)。结论通过五子散对脐周进行热敷能有效地改善脓毒症患者的胃肠道临床症状,显著减少胃残留量及降低膀胱压,降低GAS水平及APACHE II评分,其改善胃肠功能机制可能与五子散药材含有调节胃肠激素水平的成分有关。
OBJECTIVE To study the effect of Wuzi powder fomentation on gastrointestinal function and gastrointestinal hormone in patients with severe sepsis and explore its possible mechanism. METHODS Sixty patients with sepsis in Intensive Care Unit( ICU)of Guangzhou Hospital of Integrated Traditional Chinese and West Medicine were selected and randomly divided into control group( n =30) and treatment group,n = 30). Conventional treatment was given to two groups. The treatment group using Wuzi powder fomentation warmed on the belly,control group were given the same procedure with hot-water bag. Observed the changes of clinical symptoms and recorded gastric residual volume,intra-abdominal pressure,serum gastrin( GAS) and acute physiology and chronic health evaluaction II( APACHE II) score before the treatment and 3、7 days. RESULTS The effective rates of clinical gastrointestinal effect in the treatment group and the control group were 73. 3% and 50. 0%. The treatment group had statistical significant difference( P < 0. 05).Compared to the control group,the defecation frequency were reduced and bowel sounds recovery time were shorten in treatment group( P<0.05),besides the enteral nutrition were increased( P < 0. 01). After 3 days treatment,gastric residual volume,intra-abdominal pressure,GAS and APACHE II score decreased in both groups. After 7 days treatment,the improvement of the above indexes in treatment group were more significant than that of control group( P<0.01). CONCLUSION Wuzi powder fomentation can effectively improve gastrointestinal function in patients with sepsis. The mechanism of improving gastrointestinal function may be related to the composition of the contents through the regulation of gastrointestinal hormone level.

关键词(KeyWords)： 五子散热敷包;脓毒症;胃肠功能;胃泌素
Wuzi powder fomentation;sepsis;gastrointestinal function;gastrin

Abstract:

Keywords:

基金项目(Foundation): 广州市花都区科技计划项目(16-HDWS-060)

作者(Author): 余应嘉,叶淑芳,杨天化,毕伟彬,欧阳勇
YU Yingjia,YE Shufang,YANG Tianhua,BI Weibin,OUYANG Yong

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