| 引用本文: |
聂宇嵩, 全文娟, 邓彪, 李振龙.六君焦仙汤改善脓毒症急性胃肠功能障碍的临床观察[J].湖南中医药大学学报,2025,45(1):153-157[点击复制] |
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| 六君焦仙汤改善脓毒症急性胃肠功能障碍的临床观察 |
| 聂宇嵩,全文娟,邓彪,李振龙 |
| (湖南中医药大学附属常德医院重症医学科, 湖南 常德 415000) |
| 摘要: |
| 目的 探讨六君焦仙汤对脓毒症急性胃肠功能障碍患者临床症状的改善作用，并初步探讨其作用机制。方法 选取2022年12月至2023年12月于湖南中医药大学附属常德医院重症医学科收治的100例脓毒症急性胃肠功能障碍脾胃气虚型患者进行回顾性研究。采用常规西医治疗的患者分为对照组，在常规治疗的基础上给予六君焦仙汤治疗的患者分为观察组，每组50例，两组疗程均为14 d。统计两组患者治疗前后腹腔内压力（IAP），胃残留量（GRV），胃肠黏膜内pH值（pHi），血清淀粉样蛋白A(SAA)，超敏C反应蛋白（hs-CRP）、降钙素原（PCT）水平，肠道菌群变化，免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)水平。结果 与对照组相比，观察组治疗后IAP、GRV、pHi、SAA、hs-CRP、PCT下调（P<0.05）,IgG、IgM、IgA上调（P<0.05）；肠道菌群中，乳酸杆菌、双歧杆菌数量更高，而肠杆菌、肠球菌、拟杆菌和产气荚膜梭菌数量更低（P<0.05）。结论 在常规西医的治疗方案上增加六君焦仙汤可有效改善脓毒症急性胃肠功能障碍患者的胃肠道功能，减少炎症反应，平衡肠道菌群，提高免疫力，具有一定的临床应用价值。 |
| 关键词: 六君焦仙汤 脓毒症 胃肠功能障碍 腹内压 胃残余量 胃黏膜 炎性因子 |
| DOI：10.3969/j.issn.1674-070X.2025.01.025 |
| 投稿时间：2024-07-24 |
| 基金项目:湖南省卫生健康委员会区域联合项目(20201324);常德市技术研发和技术创新引导项目(CDKJJ20220355);湖南中医药大学联合院校基金重点项目(2021XJJJ070,2024XYLH114);湖南中医药大学一般项目(2022XYLH060)。 |
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| Clinical observation of Liujun Jiaoxian Decoction in reducing sepsis-induced acute gastrointestinal dysfunction |
| NIE Yusong, QUAN Wenjuan, DENG Biao, LI Zhenlong |
| (Department of Intensive Care Medicine, Changde Hospital Affiliated with Hunan University of Chinese Medicine, Changde, Hunan 415000, China) |
| Abstract: |
| Objective To explore the effects of Liujun Jiaoxian Decoction on reducing clinical symptoms of patients with sepsis-induced acute gastrointestinal dysfunction, and to preliminarily explore its mechanism of action. Methods A retrospective study was conducted on 100 patients with sepsis-induced acute gastrointestinal dysfunction of spleen stomach qi deficiency pattern who were admitted to the Intensive Care Medicine Department of Changde Hospital Affiliated with Hunan University of Chinese Medicine from December 2022 to December 2023. Patients receiving conventional Western medicine treatment were assigned to the control group, while patients receiving Liujun Jiaoxian Decoction in addition to conventional treatment were assigned to the observation group, with 50 patients in each group. The treatment course for both groups was 14 days. Statistical analyses were performed on the intra-abdominal pressure（IAP）, gastric residual volume（GRV）, intramucosal pH（pHi）, serum amyloid A（SAA）, highsensitivity C-reactive protein（hs-CRP） and procalcitonin（PCT） levels, changes in intestinal flora, and levels of immunoglobulin G（IgG）, immunoglobulin M（IgM）, and immunoglobulin A（IgA） before and after treatment in both groups of patients. Results Compared with the control group, the observation group showed significant decreases in IAP, GRV, pHi, SAA, hs-CRP, and PCT levels（P＜0.05）, as well as significant increases in IgG, IgM, and IgA levels（P＜0.05） after treatment. In terms of intestinal flora, the observation group had higher numbers of Lactobacillus and Bifidobacterium, and lower numbers of Enterobacter, Enterococcus, Bacteroides, and Clostridium perfringens（P＜0.05）. Conclusion Adding Liujun Jiaoxian Decoction to the conventional Western medicine treatment regimen can effectively improve gastrointestinal function, reduce inflammatory responses, balance intestinal flora, and enhance immunity in patients with sepsis-induced acute gastrointestinal dysfunction, demonstrating certain clinical application value. |
| Key words: Liujun Jiaoxian Decoction sepsis gastrointestinal dysfunction intra-abdominal pressure gastric residual capacity gastric mucosa inflammatory factors |
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