摘要
目的:观察中药肠道去污疗法对创伤后脓毒症患者动脉血乳酸水平、清除率及氧合指数的影响。方法:60例患者随机平均分入治疗组和对照组。治疗组采用通腑净化汤和西医常规治疗,对照组仅采用西医常规治疗。观察治疗前以及治疗6 h、12 h、24 h、48 h后动脉血乳酸水平、清除率及氧合指数情况。结果:治疗6 h后治疗组乳酸浓度以及乳酸清除率与对照组比较,差异有显著性意义(P<0.05),治疗12 h、24 h、48 h后比较,差异有非常显著性意义(P<0.01)。治疗后,2组各时间段乳酸浓度与治疗前比较,差异均有显著性意义(P<0.05)。治疗12 h、24 h、48 h后2组氧合指数比较,差异有非常显著性意义(P<0.01)。治疗后,2组各时间段氧合指数与治疗前比较,差异均有显著性意义(P<0.05)。2组患者治疗时间超过48 h的死亡率比较,治疗组为6.67%(2/30),对照组16.67%(5/30),2组比较,差异有显著性意义(P<0.05)。结论:中药肠道去污结合西医常规治疗能提高脓毒症患者的氧利用率以及乳酸清除率,改善全身氧代谢状况,降低死亡率。
Objective. To observe the effect of intestinal decontamination with Chinese medicine on arterial blood lactate level, lactate clearance rate and oxygenation index in patients with post-traumatic sepsis. Methods. Sixty qualified patients were evenly and randomly divided into treatment group and control group. The treatment group was given routine western medicine and TonJu Jinghua decoction for intestinal decontamination, and the control group was given routine western medicine alone. The arterial blood lactate level, lactate clearance rate and oxygenation index in patients were monitored before treatment, and 6, 12, 24 and 46 hours after treatment. Results- The arterial blood lactate level and lactate clearance rate in the treatment group differed from the control group 6 hours after treatment（P〈 0.05）, and markedly differed from the control group 12, 24 and 48 hours after treatment（P〈0.01）. The lactate level in both groups after treatment differed from those before treatment（P〈 0.05）. The difference of oxygenation index was markedly significant between the two groups 12, 24 and 48 hours after treatment（P 〈 0.01）, and the difference of oxygenation index in both groups was also significant before and after treatment（P〈 0.05）. The mortality after medication time over 48 hours was 6.67% （2/30） in the treatment group and was 16.67% （5/30） in the control group（P 〈0.05）. Conclusion. Intestinal decontamination with Chinese medicine plus routine western medicine shows certain effect on increasing oxygen utilization rate and lactate clearance rate, improving the general oxygen metabolism, and reducing mortality in patients with post-traumatic sepsis.
出处
《新中医》
CAS
2014年第3期61-63,共3页
New Chinese Medicine
基金
河南省科技厅成果[编号:豫科鉴(字2013)第345号]
关键词
脓毒症
肠道去污
通腑净化汤
乳酸
乳酸清除率
氧合指数
Sepsis., Intestinal decontamination
Tongfu Jinghua decoction
Lactate
Lactate clearance rate
Oxygenation index
