目的:探究基于"肺-肠"轴理论运用宣肺通腑法保护肠屏障防治老年脓毒症急性胃肠损伤的临床效果。方法:选择2022年1月—2023年6月收治的90例老年脓毒症急性胃肠损伤患者为研究对象，按随机数字表法分为对照组和试验组，每组45例。对照组给予常规治疗(包括吸氧、抗感染、肠内营养支持等)，试验组给予常规治疗联合宣肺通腑法治疗。比较两组的临床疗效、治疗前后的中医证候积分(包括腹痛腹胀、便秘、倦怠乏力等)、炎症因子水平[包括 C 反应蛋白(C-reactive protein，CRP)、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)]以及健康评分、器官衰竭评分、不良反应发生率。结果:两组治疗前的中医证候积分、炎症因子水平、健康评分及器官衰竭评分比较均差异无统计学意义(均P＞0。05)。治疗7 d后，试验组患者的治疗总有效率为97。78％，高于对照组的84。44％(P＜0。05);两组患者的中医证候积分均下降(P＜0。05)，且试验组低于对照组(P＜0。05)。治疗7 d后，两组患者的炎症因子水平、健康评分及器官衰竭评分均下降，且试验组低于对照组(P＜0。05)。试验组患者的不良反应发生率为2。22％，低于对照组的13。33％(P＜0。05)。结论:基于"肺-肠"轴理论运用宣肺通腑法保护肠屏障防治老年脓毒症急性胃肠损伤的临床效果显著，不仅能有效减轻患者机体的炎症因子水平和降低器官衰竭程度，还有助于促进患者胃肠道功能修复，减少不良反应的发生。
Clinical study on the application of the"lung-gut"axis theory and Xuanfei Tongfu method to protect the intestinal barrier in the prevention and treatment of acute gastrointestinal injury in elderly sepsis
Objective:To investigate the clinical effect of the Xuanfei Tongfu method based on the"lung-gut"axis theory for protecting the intestinal barrier in the prevention and control of septic-induced intestinal injury in elderly patients.Methods:A total of 90 elderly patients with sepsis-induced intestinal injury admitted to our hospi-tal from January 2022 to June 2023 were selected and were divided into the control group and the experimental group according to the random number table method,with 45 cases in each group.The control group was treated with conventional treatment,including oxygen inhalation,anti-infection,enteral nutrition support and the experi-mental group was treated with the Xuanfei Tongfu method combined with conventional treatment.Compare the clinical efficacy,traditional Chinese medicine(TCM)scores(abdominal pain,constipation,tired and weak)before and after treatment,the levels of the inflammatory reaction levels(C-reactive protein[CRP],IL-6,tumor necrosis factor-α[TNF-α]),health score,organ failure score,and the incidence rate of adverse reactions between the two groups of patients.Results:After seven days of treatment,the total clinical effective rate in the experimental group was 97.78％,which was higher than that 84.44％in the control group(P＜0.05).The TCM syndrome score of both groups decreased,with the experimental group showing a lower score than the control group(P＜0.05).After seven days of treatment,the inflammatory reaction levels of both groups decreased,with the experi-mental group showing lower levels than the control group(P＜0.05).The health scores and organ failure scores of both groups decreased(P＜0.05),with the experimental group showing lower scores than the control group(P＜0.05).The incidence rate of adverse reactions in the experimental group was 2.22％,which was lower than 13.33％in the control group(P＜0.05).Conclusion:The clinical efficacy of the Xuanfei Tongfu method based on the"lung-gut"axis theory in the treatment of elderly patients with sepsis-induced intestinal injury is remarkable.It can not only effectively reduce the inflammatory reaction levels and the degree of body organ failure but also help to promote gastrointestinal repair in patients and reduce adverse reactions.
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