基于文献分析的中医药治疗脓毒症胃肠功能障碍用药特点分析
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摘要
目的分析随机对照研究文献关于中医药治疗脓毒症胃肠功能障碍用药特点和规律。方法检索CNKI、维普、万方(2000年1月至2017年10月)获取中医药治疗脓毒症胃肠功能障碍的研究文献,根据纳入、排除标准筛选文献。采用文献逻辑学及信息定量统计法建立用药数据库,对中药治疗脓毒症胃肠功能障碍患者用药频次、功效、四气五味及归经进行统计分析。结果口服或鼻饲给药出现频次前6位常用中药是大黄,人参类,炙甘草,枳实,白术,厚朴;前6类中药是补虚药(补气药为主),清热药,理气药,泻下药,化湿药,温里药;前3位归经是脾经、胃经和肺经;温性药物多于寒性药物。灌肠给药出现频次前5位中药分别是大黄、芒硝、枳实、厚朴、生黄芪;前5类中药是泻下药、化湿药、理气药、补气药、温里药;前3位归经为脾经、胃经和大肠经;寒性药物多于温性药物。结论口服或鼻饲给药与灌肠给药治疗脓毒症胃肠功能障碍用药特点不同,大黄是最常用中药,攻下法是在治疗脓毒症胃肠功能障碍中发挥了重要作用;同时务必顾护脾胃,辨证使用健脾益气、清热、理气化湿及温里等治法。
Objective: To systematically analyze the characteristics of Chinese herbs on sepsis with gastroenteric dysfunction based on literature analysis. Methods: Medical journals from January,2000 to October,2017 in CQVIP,Wanfang data and CNKI were searched and screenedby inclusion and exclusion criteria. With literature logics and quantitative information statistical method,the frequency and different effects of Chinese herbs,four properties and five tastes and channel tropism in the treatment of sepsis with gastroenteric dysfunction were found out. Results: The top 6 commonly single herb by oral or nasal feeding were Rhubarb,Ginseng class,Grilled liquorice,Immature Bitter Orange,Rhizoma Atractylodis Macrocephalae and Mangnolia officinalis. The top 6 kinds of traditional Chinese medicine were supplementing the asthenia drugs(mainly for supplementing qi),clearing away heat,regulating qi,reducing diarrhea,dampness,and warming the interior. The top 3 channel tropism were spleen channel,stomach channel and lung channel. There were more cold property of drug than warm ones. The top 5 commonly single herb by enema therapy were Rhubarb,Mirabilite,Immature Bitter Orange,Mangnolia officinalis and Astragalus membranaceus. The top five types of traditional Chinese medicine by enema therapy were purgating drugs,resolving dampness drugs,Qi-regulating drugs and restoring qi drugs. The top 3 types of herb channel tropism were the spleen channel,stomach channel and large intestine channel. There were less cold property of drug than warm ones. Conclusion: There are different characteristics between the drugs by oral or nasal feeding and enema therapy for sepsis with gastroenteric dysfunction. Rhubarb is the most commonly used drug. Purgating method plays an important role in the treatment of gastroenteric dysfunction of sepsis. And it is necessary to protect the spleen and stomach that rationally uses the methods of invigorating spleen,supplementing Qi,clearing heat,regulating Qi,resolving dampness and interior-warming.
Objective: To systematically analyze the characteristics of Chinese herbs on sepsis with gastroenteric dysfunction based on literature analysis. Methods: Medical journals from January,2000 to October,2017 in CQVIP,Wanfang data and CNKI were searched and screenedby inclusion and exclusion criteria. With literature logics and quantitative information statistical method,the frequency and different effects of Chinese herbs,four properties and five tastes and channel tropism in the treatment of sepsis with gastroenteric dysfunction were found out. Results: The top 6 commonly single herb by oral or nasal feeding were Rhubarb,Ginseng class,Grilled liquorice,Immature Bitter Orange,Rhizoma Atractylodis Macrocephalae and Mangnolia officinalis. The top 6 kinds of traditional Chinese medicine were supplementing the asthenia drugs(mainly for supplementing qi),clearing away heat,regulating qi,reducing diarrhea,dampness,and warming the interior. The top 3 channel tropism were spleen channel,stomach channel and lung channel. There were more cold property of drug than warm ones. The top 5 commonly single herb by enema therapy were Rhubarb,Mirabilite,Immature Bitter Orange,Mangnolia officinalis and Astragalus membranaceus. The top five types of traditional Chinese medicine by enema therapy were purgating drugs,resolving dampness drugs,Qi-regulating drugs and restoring qi drugs. The top 3 types of herb channel tropism were the spleen channel,stomach channel and large intestine channel. There were less cold property of drug than warm ones. Conclusion: There are different characteristics between the drugs by oral or nasal feeding and enema therapy for sepsis with gastroenteric dysfunction. Rhubarb is the most commonly used drug. Purgating method plays an important role in the treatment of gastroenteric dysfunction of sepsis. And it is necessary to protect the spleen and stomach that rationally uses the methods of invigorating spleen,supplementing Qi,clearing heat,regulating Qi,resolving dampness and interior-warming.
引文
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[7]张飞虎,孙雨菡,孔立,等.半夏泻心汤加减治疗脓毒症胃肠功能障碍的临床观察[J].中国中医急症,2016,25(7):1367-1369.
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[13]陈银结,张云海,苏懿,等.温下健脾法改善重度脓毒症患者胃肠功能障碍的临床研究[J].陕西中医,2016,37(8):939-941.
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[15]姜春燕,徐艳霞,郝瑞瑞,等.中药复方通腑颗粒对老年脓毒症患者肠屏障功能的影响[J].中国中西医结合杂志,2015,35(7):787-791.
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[17]通晴,胡苏.足三里穴位注射新斯的明联合大承气汤对脓毒症患者胃肠功能的影响及其机制探讨[J].中国中医急症,2017,26(6):1052-1055.
[18]王益斐,江荣林,张赟华,等.中西医结合治疗严重脓毒症不同中医证型急性胃肠损伤患者的临床研究[J].中国现代医生,2016,54(9):20-24.
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[21]周玲霞,章琳,钱雅萍.健脾理气方联合穴位按揉对肠源性脓毒症的疗效观察[J].中华中医药学刊,2012,30(6):1438-1440.
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[23]陈晓勤,秦兵.通腑泻下法对危重患者胃肠功能障碍的治疗效果评价[J].时珍国医国药,2014,25(5):1163-1165.
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