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目的:观察中药肠道去污疗法对创伤后脓毒症患者动脉血乳酸水平、清除率及氧合指数的影响。方法:60例患者随机平均分入治疗组和对照组。治疗组采用通腑净化汤和西医常规治疗,对照组仅采用西医常规治疗。观察治疗前以及治疗6 h、12 h、24 h、48 h后动脉血乳酸水平、清除率及氧合指数情况。结果:治疗6 h后治疗组乳酸浓度以及乳酸清除率与对照组比较,差异有显著性意义(P<0.05),治疗12 h、24 h、48 h后比较,差异有非常显著性意义(P<0.01)。治疗后,2组各时间段乳酸浓度与治疗前比较,差异均有显著性意义(P<0.05)。治疗12 h、24 h、48 h后2组氧合指数比较,差异有非常显著性意义(P<0.01)。治疗后,2组各时间段氧合指数与治疗前比较,差异均有显著性意义(P<0.05)。2组患者治疗时间超过48 h的死亡率比较,治疗组为6.67%(2/30),对照组16.67%(5/30),2组比较,差异有显著性意义(P<0.05)。结论:中药肠道去污结合西医常规治疗能提高脓毒症患者的氧利用率以及乳酸清除率,改善全身氧代谢状况,降低死亡率。
Objective: To observe the effect of traditional Chinese medicine intestine decontamination therapy on arterial blood lactate level, clearance rate and oxygenation index in patients with post-traumatic sepsis. Methods: Sixty patients were randomly divided into treatment group and control group. The treatment group Tongfu Purification Decoction and Western conventional treatment, the control group only conventional treatment of Western medicine. The arterial blood lactic acid level, clearance rate and oxygenation index were observed before treatment and after 6 h, 12 h, 24 h, 48 h of treatment. Results: The concentration of lactic acid and the rate of lactic acid clearance in the treatment group after 6 h treatment were significantly different from those in the control group (P <0.05). The difference was significant at 12 h, 24 h and 48 h after treatment (P <0.01). After treatment, the lactic acid concentration in each time period was significantly different from that before treatment (P <0.05). After 12 h, 24 h, 48 h, oxygenation index of the two groups was significantly different (P <0.01). After treatment, the oxygenation index in each time period was significantly different from that before treatment (P <0.05). The mortality of patients in treatment group and control group was 6.67% (2/30) and 16.67% (5/30) respectively in the two groups. The difference was significant (P <0.05). Conclusion: Traditional Chinese medicine intestine decontamination combined with conventional western medicine can improve oxygen utilization and lactic acid clearance, improve systemic oxygen metabolism and reduce mortality in sepsis patients.