浙江中西医结合杂志

潘金波.香砂六君子汤对老年脓毒症胃肠功能障碍脾胃气虚证患者肠道菌群和免疫功能的影响[J].浙江中西医结合杂志,2022,32(9):

香砂六君子汤对老年脓毒症胃肠功能障碍脾胃气虚证患者肠道菌群和免疫功能的影响

Effect of Xiangsha Liujunzi Decoction on intestinal flora and immune function in elderly patients with sepsis with gastrointestinal dysfunction and spleen-stomach-qi deficiency syndrome

投稿时间：2021-11-04 修订日期：2022-06-27

DOI：

中文关键词: 脓毒症胃肠功能障碍老年人群香砂六君子汤肠道菌群免疫功能

英文关键词:Sepsis Gastrointestinal Dysfunction Elderly Population Xiangsha Liujunzi Decoction Intestinal Flora Immune Function

基金项目:杭州市医药卫生科技项目（A20200205）

作者	单位	E-mail
潘金波^*	1.杭州市第三人民医院ICU 310009	157384345@qq.com

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中文摘要:

目的：研究香砂六君子汤对老年脓毒症胃肠功能障碍脾胃气虚证患者肠道菌群和免疫功能的影响。方法：选取2020年9月至2021年1月于杭州市第三人民医院重症医学科就诊的老年脓毒症胃肠功能障碍患者82例，随机分为对照组和中药组，分别采用西医治疗和香砂六君子汤联合西医治疗两种治疗方法，疗程均为7日。观察比较两组28天病死率、ICU住院天数，治疗前及治疗后(第7日)的序贯器官衰竭评分（SOFA）、急性生理与慢性健康评分Ⅱ（APACHE Ⅱ）、血白细胞(WBC)、降钙素原(PCT)、C反应蛋白(CRP)、胃肠疾病中医证候评分、胃肠功能障碍评分、肠道菌群（乳酸杆菌、双歧杆菌、肠杆菌、肠球菌、拟杆菌、产气荚膜梭菌）、免疫球蛋白、T淋巴细胞亚群的变化。结果：两组患者临床资料差异均无统计学意义（P＞0.05）。中药组患者治疗后的WBC、CRP、PCT、SOFA评分、APACHE Ⅱ评分、胃肠疾病中医证候评分、胃肠功能障碍评分、乳酸杆菌数量、双歧杆菌数量、肠杆菌数量、肠球菌数量、拟杆菌数量、产气荚膜梭菌数量、IgG、IgA、IgM、CD3+、CD4+/CD8+，均较治疗前有改善（P＜0.05）。同时，与对照组比较，中药组治疗后的临床疗效更优（P＜0.05）。中药组的入住ICU时间（10.65±4.38d比16.35±4.82，P＜0.01）和入院28日死亡率[5（9.52%）比6（15.0%），P＜0.01]均低于对照组。结论：香砂六君子汤可以通过调节老年脓毒症患者的肠道菌群，降低炎症反应水平，提高机体免疫功能，改善临床预后。

英文摘要:

Objective: To study the effect of Xiangsha Liujunzi Decoction on the intestinal flora and immune function of elderly patients with sepsis with gastrointestinal dysfunction and spleen-stomach-qi deficiency syndrome.Methods:Prospectively selected elderly patients with sepsis and gastrointestinal dysfunction in our hospital and randomly divided them into a control group and a traditional Chinese medicine group. They were treated with Western medicine and Xiangsha Liujunzi Decoction combined with Western medicine. The course of treatment was 7 days.Observe and compare the 28-day mortality rate, ICU hospitalization days, SOFA score, APACHE Ⅱ score, white blood cell (WBC), procalcitonin (PCT), C-reactive protein (CRP) before and after treatment (day 7) ), gastrointestinal disease TCM syndrome score, gastrointestinal dysfunction score, intestinal flora (lactobacillus, bifidobacterium, enterobacteria, enterococcus, Bacteroides, Clostridium perfringens), immunoglobulin, T Changes in lymphocyte subsets.Results: At the same time, compared with the control group, the clinical efficacy of the traditional Chinese medicine group after treatment was better, WBC , CRP , PCT , SOFA score, APACHE-Ⅱ score , TCM syndrome score for gastrointestinal diseases , gastrointestinal dysfunction score, the number of lactobacilli , the number of bifidobacteria , the number of enterobacteria , the number of enterococci. The number of Bacteroides , the number of Clostridium perfringens,IgG , IgA , IgM , CD3+ , CD4+/CD8+ (P＜0.05). The time of admission to the ICU (10.65±4.38d vs. 16.35±4.82, P<0.01) and the 28-day mortality rate [5 (9.52%) vs. 6 (15.0%), P<0.01] of the TCM group were lower than those of the control group.Conclusions: Xiangsha Liujunzi Decoction can adjust the intestinal flora of elderly patients with sepsis, reduce the level of inflammation, improve the immune function of the body, and improve the clinical prognosis.

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