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

摘要

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.%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.