摘要
目的观察附子理中汤干预广谱抗生素在治疗脓毒症时药物性肠道肠道菌群失调、抗生素相关腹泻(ADD)等的临床疗效。方法80例脓毒症且使用广谱抗生素药物的患者随机分为两组,对照组按脓毒症3.0常规治疗,治疗组在对照组基础上联合附子理中汤口服,疗程均为7 d。记录第0、3、5、7天患者粪便杆球比变化趋势,治疗前后腹泻、二重感染发生率、急性胃肠损伤分级(AGI)、急性生理与慢性健康状况(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分。结果治疗后两组杆球比值、腹泻率、艰难梭状芽孢杆菌检测阳性率相当(P>0.05),治疗组在第7天粪便杆球比值小于2.33,对照组在第5天粪便杆球比值小于2.33。治疗后两组AGI分级、APACHEⅡ评分差异有统计学意义(P<0.05)。两组治疗后SOFA评分相当(P>0.05)。结论附子理中汤具有辅助降低广谱抗生素治疗脓毒症时药物所致肠道菌群失调、ADD发生风险的作用,可能具有保护胃肠受损的临床疗效。
Objectives:To explore the Fuzi Lizhong Decoction on unbalanced intestinal microorganism and anti⁃biotic-related diarrhea(ADD)caused by broad-spectrum antibiotics for sepsis.Methods:A total of 80 patients,who met the diagnostic criteria for sepsis and used broad-spectrum antibiotics were enrolled and randomly divided into two groups,treatment group(n=40)and control group(n=40).All patients received a therapy according to the convention treatment of sepsis 3.0;apart from that,the treatment group participants were treated with Fuzi Li⁃zhong Decoction.The changes of diarrhea,incidence of double infection,ratio of coccus versus bacillus of faeces as well as scores(AGI grade,APACHEⅡscore,SOFA score)at 0,3,5,7 d were recorded and compared between two groups.Results:After treatment,ratio of coccus versus bacillus of faeces,the rate of diarrhea,and the positive rate of shuttle difficile were similar(P>0.05).The ratio of coccus versus bacillus of faeces in the treatment group was lower than 2.33 on the 7th day,and the ratio of coccus versus bacillus of faeces in the control group was less than 2.33 on the 5th day.After treatment,the differences in AGI grade and APACHEⅡscore between the two groups were statistically significant(P<0.05).The SOFA scores of the two groups were similar after treatment(P>0.05).Conclusion:The Chinese medical therapy of Fuzi Lizhong Decoction may help reduce the risk of unbal⁃anced intestinal microorganism and ADD that caused by broad-spectrum antibiotics for sepsis and may protect gas⁃trointestinal tract from damaging as adjunctive treatment.
作者
张庆
蔡阳平
刘红栓
李硕
吴京秦
寇男
Zhang Qing;Cai Yangping;Liu Hongshuan;Li Shuo;Wu Jingqin;Kou Nan(Tongzhou District Branch,Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 101100,China.)
出处
《中国中医急症》
2022年第2期287-290,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
北京市通州区科技计划项目(KJ2019CX008)。
关键词
抗生素相关腹泻
肠道菌群失调
脓毒症急性胃肠损伤
温阳健脾
附子理中汤
Antibiotic-related Diarrhea
Unbalanced intestinal microorganism
Acute gastrointestinal Injury
Warming Yang Qi and Reinforcing Spleen Qi
Fuzi Lizhong Decoction
