Clinical efficacy of laboratory indexes of Chaiqin Magao Decoction taken orally and retention enema on elderly patients with severe pneumonia complicated with gastrointestinal dysfunction
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摘要: 目的 观察柴芩麻膏汤内服结合保留灌肠对老年重症肺炎合并胃肠功能障碍(GIDF)的临床疗效及实验室指标的影响。方法 选择2018年4月-2020年6月衡水市中医医院收治的72例老年重症肺炎合并GIDF患者，按随机数字表法将之均分为2组，一组予以常规治疗被记为对照组(n=36)，一组予以常规治疗加柴芩麻膏汤内服结合保留灌肠治疗被记为观察组(n=36)。比较2组治疗7 d后的疗效及相关实验室指标。结果 治疗后，2组GIDF评分、急性生理与慢性健康评分(APACHE Ⅱ)、中医证候评分均低于治疗前，且观察组上述各评分及治疗后的胃肠功能总有效率均优于对照组(P< 0.05)。治疗后，2组血清前白蛋白(PA)、白蛋白(ALB)、胃动素(MOT)水平均高于治疗前，2组胃泌素(GAS)、二胺氧化酶(DAO)、胃肠D-乳酸(D-LA)水平均低于治疗前，且观察组改善更优(P< 0.05)。结论 柴芩麻膏汤内服结合保留灌肠治疗老年重症肺炎合并GIDF患者疗效理想，并有利于相关实验室指标的恢复。Abstract: Objective To observe the clinical efficacy of laboratory indexes of Chaiqin Magao Decoction taken orally and retention enema on elderly patients with severe pneumonia complicated with gastrointestinal dysfunction(GIDF).Methods From April 2018 to June 2020, 72 elderly patients with severe pneumonia combined with GIDF were selected Hengshui Hospital of Traditional Chinese Medicine, and they were divided into 2 groups according to the random number table method. The other group received conventional treatment and was recorded as the control group(n=36). One group who received conventional treatment + Chaiqin Magao Decoction orally and retention enema treatment was recorded as the treatment group(n=36). The efficacy and related laboratory indicators of the 2 groups after 7 days of treatment were compared.Results After treatment, the GIDF scores, acute physiology and chronic health evaluation(APACHEⅡ) scores and TCM syndrome score in the 2 groups were lower than those before, and the scores in the treatment group and the total effective rate of gastrointestinal function after treatment were better than those of the control group(P< 0.05). After treatment, the levels of serum prealbumin(PA), albumin(ALB), and motilin(MOT) in the 2 groups were higher than those before, the levels of gastrin(GAS), diamine oxidase(DAO) and gastrointestinal D-lactic acid(D-LA) in the 2 groups were lower than before, and the treatment group improved better(P< 0.05).Conclusion Chaiqin Magao Decoction taken orally and retention enema on elderly patients with severe pneumonia complicated with GIDF has an ideal curative effect, and is conducive to the recovery of relevant laboratory indicators.
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表 1 中医证候量化评分表
证候 0分 1分 2分 咳嗽 无 偶尔 持续 痰量/mL < 50 51~100 >100 痰性 白色 黄黏痰 脓痰 大便干结 无 便干 大便硬结难排 舌象 淡红、苔薄白 红、苔薄黄 绛红、苔黄腻 
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表 2 2组GIDF、APACHEⅡ及中医证候评分比较
分，X±S 组别 例数 时间 GIDF评分 APACHE Ⅱ评分 中医证候评分 对照组 36 治疗前 2.12±0.40 23.14±6.81 8.46±2.10 治疗后 0.93±0.221) 19.35±4.391) 4.63±1.061) 观察组 34 治疗前 2.15±0.38 23.27±6.77 8.49±2.07 治疗后 0.50±0.221)2) 16.68±4.231)2) 2.47±0.611)2) 与同组治疗前比较，1)P < 0.05；与对照组比较，2)P < 0.05。
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表 3 2组治疗后的胃肠功能疗效比较
例 组别 例数 显效 有效 无效 加重 总有效率/% 对照组 36 7 11 13 5 50.00 观察组 34 13 13 6 2 76.47 χ2 5.248 P 0.022
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表 4 2组实验室指标比较
X±S 组别 例数 时间 PA/ (mg·L-1) ALB/ (g·L-1) MOT/ (pg·mL-1) GAS/ (pg·mL-1) DAO/ (U·L-1) D-LA/ (mg·L-1) 对照组 36 治疗前 136.25±79.65 24.43±8.02 260.51±96.36 125.64±64.31 21.24±6.93 23.11±8.37 治疗后 213.26±71.691) 30.84±6.531) 312.84±112.531) 97.05±38.281) 13.58±3.101) 15.62±5.341) 观察组 34 治疗前 132.58±82.68 25.32±7.95 264.30±99.53 130.19±62.68 20.99±7.02 22.87±8.68 治疗后 250.06±76.171)2) 34.62±5.861)2) 386.74±126.541)2) 67.22±31.571)2) 10.48±2.921)2) 11.12±5.161)2) 与同组治疗前比较，1)P < 0.05；与对照组比较，2)P < 0.05。
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