调胃承气汤对脓毒症胃肠损伤患者胃肠功能及免疫状态的影响

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Abstract Objective To observe the effects of Tiaowei Chengqi Decoction on gastrointestinal function and immune status in patients with gastrointestinal injury caused by sepsis. Methods From October 2017 to May 2019, 56 patients with gastrointestinal injury caused by sepsis admitted to Department of Critical Care Medicine in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were selected. They were numbered according to the order of treatment and divided into control group and treatment group by using odd even number method, with 28 cases in each group. Control group was given conventional Western medicine treatment, while treatment group was given Tiaowei Chengqi Decoction, once one dose, twice a day, oral or nasal feeding, seven days as a course of treatment. Traditional Chinese medicine syndrome efficacy, bowel sound abdominal circumference, intra-abdominal pressure, scores of disease severity, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), human leukocyte antigen-DR (HLA-DR), total lymphocyte count, CD3+, CD4+, CD8+, CD4+/CD8+, natural killer (NK) cells and complications were observed between two groups. Results Total effective rate of treatment group was higher than that of control group (P < 0.05). After treatment, the bowel sound of two groups was more than that before treatment, the abdominal circumference was shorter than that before treatment, and the intra-abdominal pressure was lower than that before treatment, and the bowel sound of treatment group was more than that of control group, the abdominal circumference was shorter than that of control group, and the intra-abdominal pressure was lower than that of control group, the differences were statistically significant (P < 0.05). After treatment, the sequential organ failure assessment score and acute physiology and chronic health status Ⅱ score of two groups were lower than those before treatment, and treatment group was lower than control group, the differences were statistically significant (P < 0.05). The levels of WBC, CRP and PCT in two groups after treatment were lower than those before treatment, and those in treatment group were lower than those in control group, the differences were statistically significant (P < 0.05). After treatment, HLA-DR, total lymphocyte count, CD3+, CD4+, CD8+, CD4+/CD8+ and NK cells in two groups were higher than those before treatment, and those in treatment group were higher than those in control group, the differences were statistically significant (P < 0.05). No obvious toxic and side effects were observed in both groups. Conclusion Tiaowei Chengqi Decoction combined with Western medicine treatment can effectively improve gastrointestinal function of patients with sepsis gastrointestinal injury, benign regulation of immune state of patients, the curative effect is better than simple Western medicine treatment. It is safe and has no side effects.

Key words： Tiaowei Chengqi Decoction Sepsis Acute gastrointestinal injury Cellular immunity

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	ZHANG Xianjin LIU Min LIN Xinfeng WEN Minyong WU Sihui ZHAO Fu ZHAO Fengli▲

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ZHANG Xianjin LIU Min LIN Xinfeng WEN Minyong WU Sihui ZHAO Fu ZHAO Fengli▲. Effect of Tiaowei Chengqi Decoction on gastrointestinal function and immune status in patients with gastrointestinal injury caused by sepsis[J]. 中国医药导报, 2020, 17(25): 119-124.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I25/119

[1] 杨斌，文雅.恶性肿瘤患者并发脓毒症39例临床分析[J].中国药物与临床，2011，11（10）：1224-1226.
[2] 张保国，刘庆芳.调胃承气汤实验研究与临床新用[J].中成药，2012，34（12）：2408-2411.
[3] 范敏，李晓波.调胃承气汤的化学成分及药理作用研究进展[J].中国药房，2016，27（31）：4446-4448.
[4] 赵锋利，吴思慧，赵馥，等.调胃承气汤灌胃与灌肠对肠源性脓毒症大鼠肠上皮细胞occludin和ZO-1蛋白表达的影响[J].广州中医药大学学报，2019，36（5）：708-713.
[5] 赵锋利，赵馥，张先进，等.调胃承气汤对肠源性脓毒症大鼠血液流变学指标和凝血功能的影响[J].中国中医急症，2019，28（4）：590-593.
[6] 赵锋利，王澍欣，罗苑苑，等.调胃承气汤对肠源性脓毒症大鼠免疫功能的影响[J].中国医药导报，2019，16（17）：18-22.
[7] Rhodes A，Evans LE，Alhazzani W，et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock：2016 [J]. Crit Care Med，2017， 45（3）：486-552.
[8] Blaser AR，Malbrain ML，Starkopf J，et al. Gastrointestinal function in intensive care patients：terminology，definitions and management. Recommendations of the ESICM Working Group on abdominal problems [J]. Intensive Care Med，2012，38（3）：384-394.
[9] 中国中西医结合学会急救医学专业委员会.脓毒症中西医结合诊治专家共识[J].中华危重病急救医学，2013，25（4）：194-197.
[10] 中华中医药学会中医诊断学分会.中医常见证诊断标准（上）[J].湖南中医药大学学报，2008，28（5）：3-8.
[11] 江利冰，李瑞杰，张斌，等.2016年脓毒症与脓毒性休克处理国际指南[J].中华急诊医学杂志，2017，26（3）：263-266.
[12] Seymour CW，Liu VX，Iwashyna TJ，et al. Assessment of clinical criteria for sepsis：for the third international consensus definitions for sepsis and septic shock （sepsis-3） [J]. JAMA，2016，315（8）：762-774.
[13] Knaus WA，Draper EA，Wagner DP，et al. APACHE Ⅱ：a severity of disease classification system [J]. Crit Care Med，1985，13（10）：818-829.
[14] 国家食品药品监督管理局.中药新药临床研究指导原则[M].北京：中国医药科技出版社，2002：29-30．
[15] Stoller J，Halpin L，Weis M，et al. Epidemiology of severe sepsis：2008-2012 [J]. J Am Coll Surg，2016，31（1）：58-62.
[16] Ivanov AI. Role for actin filament turnover and a myosin Ⅱ motor in cytoskeleton-driven disassembly of the epithelial apical junctional complex [J]. Mol Biol Cell，2004， 15（6）：2639-2651.
[17] Yang H，Song Z，Jin H，et al. Protective effect of rhBNP on intestinal injury in the canine models of sepsis [J]. Int Immunopharmacol，2014，19（2）：262-266.
[18] Spindler-Vesel A，Branka B，Irena V，et al. Intestinal permeability and cytokine inflammatory response in multiply injured patients [J]. J Interferon Res，2006，26（10）：771-776.
[19] 李红梅，邢云，唐翔诩，等.小檗碱抑制脓毒症诱导的肠上皮细胞凋亡[J].中国病理生理杂志，2016，32（9）：1660-1665.
[20] Huang CT，Tsai YJ，Tsai PR，et al. Epidemiology and outcome of severe sepsis and septic shock in surgical intensive care units in Northern Taiwan [J]. Medicine，2015， 94（47）：2136.
[21] 孙庆国，赵文静，匡玉吉，等.BriCyte E6和FACSCanto Ⅱ流式细胞仪在淋巴细胞亚群分析中的对比研究[J].中国实验诊断学，2014，18（7）：1196-1199．
[22] 张艳芳，武艳丽，施红梅，等.手足口病患儿T淋巴细胞亚群与NK细胞和血清白介素、TNF-α变化的研究[J].中华医院感染学杂志，2016，26（11）：2604-2606.
[23] 李元元，王立峰，耿华，等.自身免疫性肝病患者外周血淋巴细胞亚群的频率变化及临床意义[J].临床肝胆病杂志，2014，30（5）：409-412．
[24] 陈少艳，刘基铎，肖明锋，等.淋巴细胞亚群检测在感染性疾病中的应用[J].国际检验医学杂志，2017，38（2）：206-208.
[25] 刘阳，樊蕴辉，刘晨，等.参附注射液联合低剂量氢化可的松对脓毒症多脏器功能障碍综合征患者血浆PCT和HLA-DR水平的影响[J].天津医药，2016，44（4）：501-504.
[26] Volk HD，Reinke P，Krausch D，et al. Monocyte deactivation-rationale for a new therapeutic strategy in sepsis [J]. Intensive Care Med，1996，22（4）：S474-S481.
[27] 覃月秋，廖品琥，王超，等.重症急性胰腺炎患者外周血单核细胞HLA-DR的表达及其临床意义[J].免疫学杂志，2013，29（7）：606-610.