| 徐 顺,郭 兵,王爱丽,陈 瑜,贾 卿.鼻饲中药抗休克合剂治疗重症烧伤休克期患者的疗效及对胃肠道复苏的影响[J].,2021,(12):2288-2292 |
| 鼻饲中药抗休克合剂治疗重症烧伤休克期患者的疗效及对胃肠道复苏的影响 |
| The Eurative Effect of Nasogastric Feeding Chinese Medicine Anti-shock Mixture in the Treatment of Severe Burn Shock Stage Patients and Its Influence on Gastrointestinal Resuscitation |
| 投稿时间：2021-02-05 修订日期：2021-02-28 |
| DOI：10.13241/j.cnki.pmb.2021.12.020 |
| 中文关键词: 抗休克合剂 重症烧伤 休克期 胃肠道 临床疗效 |
| 英文关键词: Anti-shock mixture Severe burn Shock stage Gastrointestinal tract Clinical efficacy |
| 基金项目:上海市浦东新区重要薄弱学科项目（PWZbr2017-05）；上海市中西医临床协作试点建设项目[ZY(2018-2020)-FWTX-1106] |
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| 中文摘要: |
| 摘要 目的：探讨中药抗休克合剂经鼻饲给药法治疗重症烧伤休克期患者的疗效及对胃肠道复苏的影响。方法：选取上海中医药大学附属第七人民医院2017年10月至2020年9月期间收治的重症烧伤休克患者共计60例，将其按照随机数字表法分为对照组和实验组，每组各30例。对照组患者进行常规抗休克治疗，实验组在常规抗休克的基础上经鼻饲法给予中药抗休克合剂治疗。观察并记录两组患者复苏前、复苏后1 d、2 d、3 d的动脉血乳酸、内毒素水平，心率、尿量及补液量，腹胀缓解肠鸣音恢复时间、肛门排气时间，消化道不良反应、消化道出血发生率及有无继发全身性感染情况。结果：两组患者经治疗后血清内毒素和动脉血乳酸水平均呈不同趋势下降，复苏后1 d、2 d两组患者实验室指标虽有降低，但两组组间比较差异不显著（P＞0.05），实验组患者复苏后3 d血清内毒素和动脉血乳酸值下降显著，且明显优于对照组，差异有统计学意义（P＜0.05）。实验组复苏后1 d、2 d补液量均较对照组更低（P<0.05）；实验组复苏后1 d、2 d尿量与对照组比较无统计学差异（P>0.05），而复苏后3 d尿量较对照组更多（P<0.05）；实验组复苏后1 d、2 d、3 d心率均优于对照组（P<0.05）。实验组腹胀缓解肠鸣音恢复时间、肛门排气时间和消化不良反应、消化道出血、继发全身性感染发生率均低于对照组(P＜0.05)。结论：经鼻饲法给予中药抗休克合剂配合西医常规抗休克治疗，可发挥中医药特色，治疗重症烧伤休克期患者临床疗效明确，有助于胃肠道复苏，降低并发症及感染机率，具有一定的临床价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the curative effect of Chinese medicine anti-shock mixture in the treatment of severe burn shock stage patients by nasogastric feeding and its effect on gastrointestinal resuscitation. Methods: A total of 60 cases of severe burn shock stage patients who were admitted to the Seventh People's Hospital Affiliated to Shanghai University of Chinese Medicine from October 2017 to September 2020 were selected. They were divided into control group and experimental group according to random number table method, with 30 cases in each group. The control group was given conventional anti-shock treatment, and the experimental group was given Chinese medicine anti-shock mixture by nasogastric feeding method on the basis of conventional anti-shock treatment. The levels of arterial blood lactic acid, endotoxin before and 1 d, 2 d and 3 d after resuscitation, heart rate, urine volume and rehydration fluids, recovery time of intestinal sound relieved by abdominal distention, anal exhaust time, incidence of digestive tract adverse reactions, gastrointestinal bleeding and with or without secondary systemic infection in the two groups were observed and recorded. Results: The levels of serum endotoxin and arterial blood lactic acid in the two groups after treatment showed different trends of decrease, the laboratory indexes in the two groups were decreased at 1 d and 2 d after resuscitation, but there was no significant difference between the two groups(P>0.05). The serum endotoxin and arterial lactic acid values in the experimental group decreased significantly at 3 d after resuscitation, and were significantly better than those in control group, with statistical significance(P<0.05). After resuscitation, the rehydration fluids in the experimental group at 1 d and 2 d after resuscitation were lower than that in the control group(P<0.05). There was no significant difference in urine volume between the experimental group and the control group at 1 d and 2 d after resuscitation (P>0.05), but urine volume at 3 d after resuscitation was higher than that in the control group(P<0.05). The heart rate in the experimental group was better than that in the control group at 1 d, 2 d and 3 d after resuscitation(P<0.05). The recovery time of intestinal sound relieved by abdominal distention, anal exhaust time, incidence rate of digestive tract adverse reactions, gastrointestinal bleeding and secondary systemic infection in the experimental group were lower than those in the control group(P<0.05). Conclusion: The nasogastric feeding Chinese medicine anti-shock mixture combined with western medicine conventional anti-shock treatment can play the characteristics of traditional Chinese medicine, and has definite clinical effect in treating severe burn shock stage patients, which is helpful to gastrointestinal resuscitation, reduce the incidence of complications and infection, and has certain clinical value. |
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