归元创疗汤对严重创伤患者血浆内毒素及TNF-α的影响.DOCVIP

临床医学论文-归元创疗汤对严重创伤患者血浆内毒素及TNF-α的影响 ??????????? 作者：杨峰，陈斌，周泽强，韩庆，杨欣建 ［摘要］? 目的? 探讨归元创疗汤对严重创伤患者血浆内毒素及TNF-α影响。方法? 从2003年12月～2004年10月收治的严重创伤患者中，选择有全身炎症反应综合征的患者22例随机分为两组。试验组10例给予常规疗法加归元创疗汤剂口服或经胃管注入，对照组12例仅给予常规疗法。受伤入院后观察至次日如无胃肠道破裂或急诊手术后无胃肠损伤者给予口服或经胃管灌入归元创疗汤（试验组），或注入生理盐水（对照组），入院后第一天和治疗后第3天采集病人外周静脉血样，检测血浆内毒素及TNF-α。收集上述资料并观察排便等情况，进行统计学分析。结果? 试验组和对照组用药前测定血浆内毒素及TNF-α之间无统计学意义，用药后3天，试验组血浆内毒素及TNF-α含量低于对照组。试验组患者排便早于对照组。结论? 归元创疗汤剂结合西医治疗可以促进患者排便，保护胃肠黏膜，减轻全身炎症反应。 ??? ［关键词］? 严重创伤；归元创疗汤；全身炎症反应综合征；内毒素；肿瘤坏死因子α ??????? Effects of Guiyuanchuangliao Decoction on the plasma levels of endotoxin and TNF-α in severe trauma patients ??? ［Abstract］? Objective? To investigate curative effect of Guiyuanchuangliao Decoction in treatment of severe trauma patients.Methods? 22 severe trauma patients with systemic inflammatory response syndrome (SIRS) and non-gastroenteral injury were randomly divided into treatment group (Guiyuanchuangliao Decoction with routine therapy，10 cases) and control group (routine therapy，12 cases).The plasma levels of endotoxin and TNF-α were detected at the time before and after 3 days of treatment with Guiyuanchuangliao Decoction.The defecation was recorded.Results? In contrast，the plasma levels of endotoxin and TNF-α of two group were no-significantly different before trying.However，after taking Guiyuanchuangliao Decoction for three days，the levels of plasma endotoxin and TNF-α were lower in treatment group than that of control group.And the defecation time of treatment group was shorter than that of control group.Conclusion? Guiyuanchuangliao Decoction taken orally combined with Western medicine can abate the degree of intestine injury，lessen the inflammatory response，ameliorate illness state of SIRS patients. ??? ［Key words］? severe trauma；Guiyuanchuangliao Decoction；systemic inflammatory response syndrome；endotoxin；tumour necrosis factor alpha ??? 严重创伤可导致多器官功能障碍综合征(Multiple organ dysfunction syndrome，MODS)，而全身炎症反应综合征(Systemic inflammatory response syndrome，SIRS)是机体在各种严重感染、