摘要
目的 研究大黄对创伤后脓毒症胃肠道机制的阻断作用。 方法 178例患者分成创伤脓毒症组、创伤脓毒症并发多器官功能障碍综合征 (MODS)两大组 ;各大组再分为大黄治疗组和对照组两亚组。观察大黄对胃肠功能障碍、循环血内内毒素和肿瘤坏死因子 -α(TNF -α)水平和MODS的影响。 结果 178例患者中 ,6 2例并发胃肠功能障碍 ,其中 38例并发MODS ;116例无胃肠功能障碍的患者中 2 0例并发MODS。胃肠功能障碍患者治疗前循环血内内毒素和TNF -α水平明显高于无胃肠功能障碍的患者 (P <0 .0 1) ;两组患者经大黄治疗后循环血内内毒素和TNF -α水平显著降低 (P <0 .0 1)。大黄对伴胃肠功能障碍的MODS有较好的疗效 ,与对照组比较 ,差异有显著性意义 (P <0 .0 5 )。 结论 胃肠功能障碍对创伤后脓毒症和MODS的病理生理机制有重要影响 ;大黄能促进胃肠功能的恢复 ,阻断创伤后脓毒症的胃肠道机制 ,对创伤后MODS的防治有重要作用。
Objective To study the blocking effects of rhubarb on the pathophysiological mechanisms of sepsis after trauma. Methods A total of 178 traumatic patients were enrolled in this study and divided into two groups, septic group and multiple organ dysfunction syndrome (MODS) group. These two groups were respectively further divided into two subgroups, rhubarb treatment group and control group. An observation was carried out on the effect of rhubarb on gastrointestinal dysfunction, levels of endotoxin and TNF-α in serum and MODS. Results Among 178 traumatic patients, developed gastrointestinal dysfunction, of which 62 cases 58 cases were complicated by MODS. Whereas only 20 cases out of 116 patients with normal gastrointestinal function developed to MODS. The levels of endotoxin and TNF-α in serum in traumatic patients with gastrointestinal dysfunction were obviously higher than that in patients with normal gut function before rhubarb treatment (P< 0.01). Rhubarb could evidently reduce the levels of endotoxin and TNF-α in serum in both groups (P< 0.01). In addition, compared with control group rhubarb had a good curative effect on MODS in patients with gastrointestinal dysfunction with a significant difference (P< 0.05). Conclusions Gastrointestinal dysfunction has a significant effect on sepsis and MODS after trauma. Rhubarb can relieve gastrointestinal dysfunction, block the pathophysiological response induced by the gut failure in septic patients after trauma and may have a good preventive and curative effect on MODS.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第1期17-19,共3页
Chinese Journal of Trauma
基金
国家自然科学基金资助项目 ( 395 70 6 88)
上海市科技发展基金资助项目 ( 0 2 41190 90 )
