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Effect of Yiqi Tongfu Zhuyu decoction enema therapy on intestinal mucosal barrier function in patients with sepsis
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- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTOLOGY
- Issue:
- 24
- DOI:
- 10.3969/j.issn.1009-3079.2009.24.020
- Key Word:
- 益气通腑逐瘀方;灌肠疗法;脓毒症;肠道黏膜屏障功能
Abstract： 目的: 观察益气通腑逐瘀方灌肠疗法对脓毒症患者肠道黏膜屏障功能的影响.方法: 将40例脓毒症患者, 随机分为治疗组(20例)与对照组(20例).2组患者均给予敏感抗生素、营养支持等常规治疗, 必要时给予机械通气治疗.治疗组在此基础上联合益气通腑逐瘀方灌肠治疗, 对照组在此基础上行等量煎药用水灌肠, 均每日2次.PCR法测定患者治疗前后外周血细菌DNA片段, 分光光度法监测其血清D -乳酸水平, 高效液相色谱法监测尿乳果糖/甘露醇(L/M)值, 观察脓毒症患者ARDS、MODS的发生.结果: 治疗7 d与14 d后, 治疗组较对照组D -乳酸水平均有显著降低(6.04±1.06 μg/L vs 8.83±0.73 μg/L;3.89±0.86 μg/L vs 7.18±0.90μg/L, 均P<0.01);治疗14 d后, 较对照组尿L/M水平有明显降低(0.0499 vs 0.0709, P<0.05);治疗结束后, 与对照组相比治疗组细菌DNA片段转阴率增高、ARDS发生率及MODS发生率均有明显降低(71.4% vs 33.3%;17.6% vs50%;0% vs 22.2%, 均P<0.05).结论: 益气通腑逐瘀方灌肠治疗能改善脓毒性患者肠道黏膜屏障功能, 降低肠道细菌、内毒素移位, 并能降低脓毒症患者ARDS、MODS的发生率.
- [1]万幸,刘倩娴,王培训.大承气汤对全身性炎症反应干预作用的实验研究[J].2003,(2).
- [2]中华医学会重症医学分会.急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南（2006）[J].2006,(12).
- [3]陈海龙,吴咸中,关凤林.中医通里攻下法对多器官功能不全综合征时肠道屏障功能保护作用的实验研究[J].2000,(2).
- [4]张艺平,韩鹏.中药抗内毒素研究新进展[J].2001,(2).
- [5]郭昌星,杨兴易,林兆奋,等.血府逐瘀汤对全身炎症反应综合征患者氧自由基的影响[J].2002,(4).
- [6]曹书华,王今达.大承气汤在多器官功能障碍综合征治疗过程中的免疫调节作用[J].2004,(12).
- [7]于泳浩,崔乃强,傅强,等.大承气颗粒对重型脓毒症促炎-抗炎反应平衡的影响[J].2004,(6).
- [8]姚咏明,盛志勇.我国创伤脓毒症基础研究新进展[J].2003,(1).
- [9]S M, Smith,R H, Eng,F, Buccini.Use of D-lactic acid measurements in the diagnosis of bacterial infections.[J].1986,154.
- [10]Ingvar Bjarnason,Andrew Macpherson,Daniel Hollander.Intestinal permeability: An overview[J].1995,108(5).
- [11]Mitchell Levy,Mitchell Fink,John Marshall,etc.2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference[J].2003,31(4).
- [12]K, Miki,R, Butler,D, Moore,etc.Rapid and simultaneous quantification of rhamnose, mannitol, and lactulose in urine by HPLC for estimating intestinal permeability in pediatric practice.[J].1996,42.
- [13]姚咏明,盛志勇 主编.脓毒症防治学[M].2008.
- [14]G A, Nieuwenhuijzen,E A, Deitch,R J, Goris.Infection, the gut and the development of the multiple organ dysfunction syndrome.[J].1996,162.
- [15]Struck J,Harbarth S,Bergmann A,etc.Mid-regional pro-adrenomedullin as a prognostic marker in sepsis: an observational study.[J].2005,9(6).
- [16]Alhava EM,Juvonen PO,Takala JA.Gut permeability in patients with acute pancreatitis.[J].2000,35(12).
- [17]T D, Kane,J W, Alexander,J A, Johannigman.The detection of microbial DNA in the blood: a sensitive method for diagnosing bacteremia and/or bacterial translocation in surgical patients.[J].1998,227.