电腹针联合承气逐瘀汤灌肠治疗脓毒症(热毒瘀阻证)的临床疗效观察

Clinical Observation on the Therapeutic Effect of Electro Abdominal Acupuncture Combined with Chengqi Zhuyu Decoction Enema in the Treatment of Sepsis (Heat Toxicity and Blood Stasis Syndrome)

摘要: 目的：探讨电腹针联合承气逐瘀汤灌肠治疗脓毒症(热毒瘀阻证)胃肠功能障碍患者的治疗效果。方法：将60例脓毒症(热毒瘀阻证)患者用中央随机系统分为观察组、对照组，每一组包含30名患者，两组在年龄、性别以及APACHEII评分方面都没有显示出统计学上的显著差异(P > 0.05)。对照组参考脓毒症治疗指南给予常规治疗和护理，观察组于常规治疗护理基础上加用电腹针联合承气逐瘀汤灌肠治疗，7 d为1个疗程。观察并比较两组施治前后的肠鸣音、腹围、APACHEII评分、SOFA评分、WBC、CRP、PCT等相应指标。结果：治疗7 d后两组主要指标均较前改善(P < 0.05)，观察组优于对照组(P < 0.05)。观察组综合有效率为90.00%高于对照组的71.67% (P < 0.05)。结论：在常规治疗和护理基础上给予电腹针联合承气逐瘀汤灌肠对脓毒症(热毒瘀阻证)患者的临床疗效优于常规西医治疗，其机制可能与脓毒症患者邪热与糟粕互结，形成燥屎而阻于肠道相关。电腹针联合中药灌肠有助于排泄肠道糟粕，防止毒素及炎性介质蓄积，进而改善胃肠功能障碍。

Abstract: Objective: To explore the therapeutic effect of electro abdominal acupuncture combined with Chengqi Zhuyu Decoction enema in the treatment of patients with sepsis (heat toxicity and blood stasis syndrome) and gastrointestinal dysfunction. Method: Sixty patients with sepsis (heat toxin stasis syndrome) were divided into observation group and control group by central randomized system, with 30 patients in each group. There were no statistically significant differences in age, gender and APACHEII scores between the two groups (P > 0.05). The control group was given routine treatment and nursing according to the treatment guidelines for sepsis, and the observation group was treated with electro abdominal acupuncture combined with Chengqi Zhuyu Decoction on the basis of conventional treatment and nursing, with a course of 7 days. Intestinal sound, abdominal circumference, APACHE II score, SOFA score, WBC, CRP, PCT and other relevant indexes were observed and compared between the two groups before and after treatment. Result: After 7 days of treatment, the main indicators of both groups improved compared to before (P < 0.05), and the observation group was better than the control group (P < 0.05), and the observation group was better than the control group (P < 0.05). The comprehensive effective rate of the observation group was 90.00% higher than that of the control group (71.67%) (P < 0.05). Conclusion: On the basis of conventional treatment and nursing, electric abdominal acupuncture combined with Chengqi Zhuyu Tang enema has a better clinical effect than conventional western medicine in patients with sepsis (heat toxin stasis syndrome). The mechanism may be related to the information of pathogenic heat and dregs in patients with sepsis, which forms dry feces and obstructs the intestine. Electro abdominal acupuncture combined with Chinese medicine enema can help to excrete intestinal dross, prevent the accumulation of toxins and inflammatory mediators, and improve gastrointestinal dysfunction.