| Objective: To verify the clinical effects of Tiao Chang Decoction enema in sepsis patients with gastrointestinal dysfunction,and to provide theoretical and clinical basis for Tiao Chang Decoction in the treatment of this disease.Methods: 60 patients with gastrointestinal dysfunction in sepsis were selected as the research object,and the design method of clinical trial was random,control and single blind.There were 30 cases in the experimental group and 30 cases in the control group.The control group was treated with conventional western medicine,and the experimental group was treated with Tiaochang decoction enema based on the treatment of the control group.The course of treatment of both groups was 7 days.The APACHE II score,SOFA score,abdominal circumference,bowel sounds,abdominal pressure(IPA),gastrointestinal dysfunction score,gastrointestinal hormones(MOT)and inflammatory indexes(WBC,CRP,PCT),quantitative score of TCM symptom grading,curative effect of gastrointestinal function,28 day mortality and length of stay in ICU were compared between the two groups before and after treatment,To monitor the safety indexes and adverse reactions of patients in order to aeeseement the clinical effect and reliability of Tiaochang decoction.result:1.Comparison of quantitative score of TCM symptoms and curative effect of gastrointestinal function: the quantitative score of TCM symptoms of the two groups changed with the change of time factors,time effect F=421.067,P<0.05;Different treatment methods can make the quantitative score of TCM symptoms of patients different.The grouping effect is F=17.785,P<0.05.The total effective rate of gastrointestinal function after treatment was 70.0% in the experimental group and40.0% in the control group.The comparison between the two groups showed that the curative effect of the experimental group was better than that of the control group(P< 0.05).3.Comparison of APACHE II score: the APACHE II score of the two groups changed with the change of time factors,and the time effect APACHE II score F=210.376,P<0.05;Different treatment methods can make the APACHE II score of patients different.The grouping effect is F=14.960,P<0.05;APACHE II scores at different time points were different due to different treatment methods.Time *grouping effect F=10.964,P<0.05.4.Comparison of SOFA score: the SOFA score:of the two groups changed with the change of time factors,time effect F=70.048,P<0.05;Different treatment methods can make patients’ SOFA score different.The grouping effect is F=21.665,P<0.05;There was no significant difference in SOFA score at different time points due to different treatment methods.The time * grouping effect F=1.602,P=0.206>0.05.5.Comparison of abdominal circumference and abdominal pressure: the abdominal circumference and abdominal pressure of the two groups changed with the change of time factors.The time effect of abdominal circumference(F=10.869,P<0.05)and abdominal pressure(F=47.275,P<0.05);There were significant differences in abdominal circumference and intraperitoneal pressure after treatment.The grouping effect was abdominal circumference(F=14.412,P<0.05)and intraperitoneal pressure(F=14.372,P<0.05);The abdominal circumference and abdominal pressure at different time points were different due to the difference of treatment methods.The time * grouping effect was abdominal circumference(F=8.931,P=0.004<0.05)and intraperitoneal pressure(F=4.979,P<0.05).6.Comparison of gastrointestinal dysfunction scores: the gastrointestinal dysfunction scores of the two groups changed with the change of time factors,time effect F=316.933,P<0.05;Different treatment methods can make the score of gastrointestinal dysfunction different.The grouping effect is F= 21.924,P< 0.05;The score of gastrointestinal dysfunction at different time points was different due to the difference of treatment methods.Time * Group F=11.922,P<0.05.7.Comparison of motilin(MOT): mot in the two groups changed with the change of time factors,time effect F=30.247,P<0.05;Different treatment methods can make patients have different mot.The grouping effect is F=12.911,P<0.05;Mot at different time points was different due to different treatment methods.Time *Group F=3.759,P=0.029<0.05.8.Comparison of inflammatory indexes(WBC,CRP and PCT)before and after treatment: WBC,CRP and PCT in the two groups changed with the change of time factors.Time effects WBC(F =37.963,P<0.05),CRP(F=34.651,P<0.05)and PCT(F= 146.682,P<0.05);Different treatment methods can make differences in WBC,CRP and PCT.The grouping effects are WBC(F=10.435,P<0.05),CRP(F=7.886,P<0.05)and PCT(F=10.616,P<0.05);WBC and CRP at different time points were different due to different treatment methods.Time * group WBC(F=1.491,P=0.234< 0.05)CRP(F=4.374,P=0.017<0.05);9.Comparison of 28 day mortality and length of stay: the 28 day mortality in the experimental group was lower than that in the control group(P<0.05),and there was no difference in the length of stay between the two groups(P>0.05).10.Safety analysis: there were no serious adverse reactions during the treatment.There was no difference in the main safety indexes of creatinine(Cr),urea nitrogen(BUN),aspartate aminotransferase(ALT)and alanine aminotransferase(AST)before and after treatment(P>0.05).Conclusion: For patients with gastrointestinal dysfunction of sepsis,the application of tiaochang decoction enema has definite clinical efficacy.It can reduce the clinical symptoms of patients with gastrointestinal dysfunction in sepsis,improve gastrointestinal function,adjust the level of MOT,reduce the level of inflammatory indexes(WBC,PCT,CRP)to a certain extent,reduce the quantitative integral of TCM symptoms,and improve the effective rate of clinical treatment,Reduce the 28 day mortality,indicating that the clinical efficacy of integrated traditional Chinese and Western medicine in the treatment of sepsis gastrointestinal dysfunction is more prominent,and the formula of tiaochang decoction is safe and reliable,without adverse reactions. |
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