大黄牡丹汤治疗腑实血瘀型脓毒症胃肠道功能障碍临床观察OA

Objective:To observe the clinical efficacy of Dahuang-Mudan Decoction combined with conventional treatment for gastrointes-tinal dysfunction in sepsis patients presenting with excessfuorgan and bloodstasis syndrome.Methods:A total of 80 patients diagnosed with gastrointestinal dysfunction secondary to sepsis with excessfuorgan and bloodstasis syndrome,admitted to Anyang Hospital of Tradi-tional Chinese Medicine from March 2024 to March 2025,were enrolled and randomly divided into the control group and the study group,with 40 cases in each group.Patients in the control group received conventional treatment alone,while those in the study group were additionally administered Dahuang-Mudan Decoction,one dose per day prepared by concentrated decoction,given orally or via gas-tric tube.Both groups received oneweek treatment.The clinical efficacy,and changes in TCM symptom scores,gastrointestinal dysfunc-tion scores,antral motility index,intestinal mucosal barrier function indicators[diamine oxidase(DAO),intestinal fatty acidbinding protein(IFABP)]and intraabdominal pressure before and after treatment were compared between the two groups.Serum levels of inter-leukin-6(IL-6),neutrophil count(NEU)and lymphocyte count(LYM)were detected.The neutrophil to lymphocyte ratio(NLR)was calculated.Sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,occurrence of adverse reactions and 28 day mortality were recorded.Results:The effective rate was 77.50％in the control group versus 95.00％in the study group,with a statistically significant difference between the two groups(P<0.05).After treatment,TCM symp-tom scores and gastrointestinal dysfunction scores declined in both groups,with statistically significant differences between the two groups(P<0.05).Antral motility index was elevated,whereas Dlactate,DAO,IFABP and intraabdominal pressure decreased in both groups,with statistically significant differences between the two groups(P<0.05).Levels of procalcitonin(PCT),IL6 and NLR were reduced in both groups,showing statistically significant differences between the two groups(P<0.05).SOFA and APACHEⅡ scores were markedly lowered in both groups,with statistically significant differences between the two groups(P<0.05).The28 day mortality was lower in the study group than that in the control group,yet no statistically significant difference was observed(P>0.05).No severe adverse reactions occurred during treatment in either group.Conclusion:Adjuvant Dahuang-Mudan Decoction on the basis of convention-al therapy can further improve the clinical efficacy,relieve symptoms and gastrointestinal dysfunction in septic patients.