本文關(guān)鍵詞： 大承氣湯化裁膿毒癥保留灌腸凝血功能　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:采用大承氣湯化裁保留灌腸,觀察其治療膿毒癥(瘀毒內(nèi)阻型)的臨床療效及對(duì)凝血功能的影響,為臨床上中西醫(yī)結(jié)合治療膿毒癥提供新的參考。方法:本研究采取隨機(jī)對(duì)照原則,選取符合納入標(biāo)準(zhǔn)的64例患者,試驗(yàn)組及對(duì)照組各32例。試驗(yàn)組應(yīng)用大承氣湯化裁保留灌腸結(jié)合西醫(yī)治療,對(duì)照組應(yīng)用溫水保留灌腸及西醫(yī)治療�；颊咴诩{入時(shí)、第三天、第七天進(jìn)行SOFA評(píng)分、APACHE-II評(píng)分及中醫(yī)證候積分,記錄其體溫、呼吸頻率等一般指標(biāo),并抽取外周動(dòng)靜脈血進(jìn)行凝血四項(xiàng)(活化部分凝血激酶時(shí)間、血漿凝血酶時(shí)間、凝血酶原時(shí)間、纖維蛋白原)、D-二聚體、乳酸、血小板指標(biāo)的檢測(cè)。結(jié)果:試驗(yàn)組大承氣湯化裁保留灌腸治療后第三天、第七天,呼吸、凝血四項(xiàng)、D-二聚體、乳酸、血小板、APACHE-II評(píng)分、SOFA評(píng)分、中醫(yī)證候積分的變化幅度與對(duì)照組相比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。且大承氣湯化裁保留灌腸治療后第七天與第三天檢測(cè)指標(biāo)水平相比改善較為顯著。試驗(yàn)組治療后第七天,體溫的變化幅度與對(duì)照組相比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.大承氣湯化裁保留灌腸可以提高膿毒癥(瘀毒內(nèi)阻型)患者的臨床療效。2.大承氣湯化裁保留灌腸可以有效降低膿毒癥(瘀毒內(nèi)阻型)患者凝血四項(xiàng)、D-二聚體和乳酸水平,升高血小板計(jì)數(shù)水平,改善患者的呼吸及體溫情況。3.大承氣湯化裁保留灌腸有效降低膿毒癥(瘀毒內(nèi)阻型)患者的APACHE-II評(píng)分、SOFA評(píng)分及中醫(yī)證候積分。
[Abstract]:Objective: using Dachengqi Decoction retention enema, observe the treatment of sepsis (stasis resistance type) clinical efficacy and effect on blood coagulation function, provide a new reference for the clinical combination of Chinese medicine and Western medicine in the treatment of sepsis. Methods: This study adopts random control principle, selected 64 cases of inclusion. Standard patients, test group and control group with 32 cases in each group. The experimental group used Dachengqi Decoction retention enema combined with western medicine treatment, the control group used water enema and Western medicine treatment. Patients in third days, seventh days, SOFA score, APACHE-II score and TCM syndrome score, to record the temperature. Respiratory frequency index, and extraction of peripheral venous blood coagulation four (activated partial thromboplastin time, thrombin time, prothrombin time, fibrinogen), two D- dimer, lactic acid, blood platelet index detection. Results: the experimental group. Gas Decoction retention enema in the treatment of third days, seventh days after breathing, four items of blood coagulation, two D- dimer, lactic acid, platelet, APACHE-II score, SOFA score, TCM syndrome score changes compared with the control group, the difference was statistically significant (P0.05). And Dachengqi Decoction retention enema after seventh days and third days compared to the level of detection index improved significantly. Seventh days after treatment in experimental group, the body temperature changes compared with the control group, the difference was statistically significant (P0.05). Conclusion: 1. Dachengqi Decoction retention enema can improve sepsis (stasis resistance type) clinical the efficacy of.2. in patients with Dachengqi decoction retention enema can effectively reduce sepsis (stasis resistance type) patients with coagulation four, two D- dimer and lactate levels, elevated levels of platelet count, improve the patient's breathing and temperature.3. Dachengqi Decoction retention enema The APACHE-II score, SOFA score and TCM syndrome score were effectively reduced in patients with sepsis (blood stasis syndrome).

【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R459.7

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