摘要
[目的]观察大黄灌肠+中药热敷联合西药治疗脓毒症疗效。[方法]使用随机平行对照方法,将48例住院患者按就诊顺序号方法简单随机分两组。对照组24例抗感染、控制血糖、营养支持、预防应激性溃疡等基础支持治疗。治疗组24例中药保留灌肠,取药液200mL,加温37℃,体位根据患者依从性,肛管前端涂润滑液,插入直肠10~15cm,使药液徐徐进入直肠,药液注完后捏紧肛门,徐徐拔出肛管,勿使药液流出,保留>0.5h,保留越长时间越好;中药热敷,取与药液同煮后的热毛巾拧干,折叠成约10cm×10cm大小,待温度降至患者能接受温度时轻轻敷于患者神阙处,30min/次,1次/d;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、补体C3(C3)、补体C4(C3)、C反应蛋白(CRP)、前白蛋白(PA)、白蛋白(ALB)、急性生理与慢性健康评分(APACHEⅡ评分)、不良反应。治疗1疗程,判定疗效。[结果]APACHEⅡ评分疗效组间无明显差异(P>0.05)。C3、C4、CRP、PA、ALB两组均有改善(P<0.05,P<0.01),C3、C4、CRP、ALB治疗组改善均优于对照组(P<0.05,P<0.01);PA组间无明显差异(P>0.05)。[结论]大黄灌肠+中药热敷联合西药治疗脓毒症,疗效满意,改善血液循环,加速体内废物代谢,明显改善急性时相反应蛋白,提高机体免疫力及生存率,从而减低死亡率,值得推广。
[Objective] Observe the rhubarb enema＋TCM heat compress combined western medicine curative effect in the treatment of sepsis. [Methods] Using random parallel control method, The method of 48 cases of hospitalized patients in clinic serial number simply divided into two groups at random. The control group 24 cases, For fluid resuscitation, anti-infection, control blood sugar, nutritional support, prevention of stress ulcer and other basic support treatment. The treatment group 24 cases, TCM hot compress, take with liquid after boiling hot towel dry, fold into 10 cm by 10 cm size, for the temperature when the temperature dropped to patients can accept apply gently on the CV 8 patients, 30mirdtimes, l/d; Western medicine treatment with the control group. Continuous treatment of 7 d for 1 course of treatment; Observation of clinical symptoms, C3 （C3）, complement C4 （C3）, c-reactive protein （CRP） and prealbumin （PA）, albumin （propagated）, acute physiology and chronic health evaluation （APACHE [[ score）, adverse reactions. As a course treatment, judge curative effect. [Results] APACHE no significant difference between groups （P〉0.05）.C3, C4, CRP, PA, ALB two groups were improved （P〈0.05, P〈0.01）, C3, C4, CRP, ALB in treatment group was better than the control group （P〈0.05, P〈0.01）; no significant difference between the PA group （P〉0.05）. [Conclusion] Rhubarb enema＋TCM hot compress combined western medicine in the treatment of sepsis, curative effect satisfaction, improve blood circulation, accelerate the metabolism of waste and greatly improve the acute phase reaction protein, enhance immunity and survival rates, thereby reducing mortality, is worth promoting.
出处
《实用中医内科杂志》
2017年第4期29-32,共4页
Journal of Practical Traditional Chinese Internal Medicine
