Objective. To investigate the effects of Shenling Chengqi decoction combined with routine treatment on gastrointestinal function and immune status of patients with gastrointestinal injury in severe sepsis. Methods. 160 patients with sepsis were randomly divided into a control group ( n = 80 ) and observation group ( n = 80 ). The control group was given routine treatment such as anti-infection and vasoactive drugs. The observation group was treated with Shenling Chengqi decoction on the basis of routine treatment for 7 days. The improvement of gastrointestinal symptoms, nutritional status, gastrointestinal dynamics, inflammatory response, and immune function was observed before and after treatment. The outcome indicators were evaluation of gastrointestinal symptoms, evaluation of disease severity, nutritional status, gastrointestinal dynamic indexes, inflammatory indexes, and immune function indexes. SPSS 22.0 statistical software was used for data processing. The paired t -test was used for comparison before and after treatment. Results. Compared with the control group, the disappearance time of reflux, vomiting, and recovery time of bowel sounds in the observation group were significantly shorter ( P < 0.05 ), and the number of defecation per day was significantly higher than that in the control group ( P < 0.05 ). After 3 and 7 days of treatment, the APACHE II score, SIRS score, serum gas, IgA, IgM, serum hs-CRP, TNF, and PCT of the two groups were significantly lower than those before treatment ( P < 0.05 ), and the scores of the observation group were significantly lower than those of the control group ( P < 0.05 ). The levels of SS and MOT were significantly higher than those before treatment ( P < 0.05 ). After 7 days of treatment, the levels of serum Hb, ALB, and PA in the two groups were significantly higher than those before treatment ( P < 0.05 ), and the nutritional status in the observation group was significantly higher than that in the control group ( P < 0.05 ). Conclusion. Shenling Chengqi decoction can effectively improve gastrointestinal symptoms, nutritional status, and gastrointestinal dynamics in patients with sepsis. It has high safety and is worthy of clinical promotion.
Multiple organ dysfunction syndrome (MODS) is a key factor that leads to death in elderly patients with sepsis. Therefore, early prevention and treatment of gastrointestinal dysfunction (GIDF) in elderly patients with sepsis is an important measure to prevent MODS occurrence. This research explores the correlation between intestinal microflora and GIDF in elderly patients with sepsis and provides ideas for the prevention and treatment of GIDF in elderly patients with sepsis. In this study, 152 patients with sepsis (122 patients with sepsis and GIDF) treated in the Third Affiliated Hospital of Yunnan University of Chinese Medicine from January to September 2019 were selected as the sepsis group and 100 elderly who had normal physical examination results were selected as the control group. The common intestinal microflora of the two groups was compared. Patients with sepsis and GIDF were treated as the GIDF group and the other patients with sepsis were treated as the non-GIDF group. The common intestinal microflora, gastrointestinal indicators, serum inflammatory factors, and immune function indices were compared between the two groups. Correlation analysis of the observed indices with statistical significance was carried out. The results showed 152 patients with sepsis and 122 patients with sepsis and GIDF; thus, the incidence of sepsis with GIDF was 80.26%. The total average score of sepsis with GIDF was 3.61±0.09. There was no statistically significant difference in GIDF scores of patients ages 65–75 and > 75 years old. The number of Bifidobacterium and Lactobacillus in elderly patients with sepsis was lower and the number of Escherichia coli was higher than in the control group. In elderly patients with sepsis, the number of Bifidobacterium and Lactobacillus in the GIDF group was lower and the number of E. coli was higher than in the non-GIDF group. White blood cell (WBC) count, procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), gastrin (GAS), and diamine oxidase (DAO) in GIDF patients were higher and motilin (MOT), CIT (CIT), CD4+, and CD8+ were lower than in the non-GIDF group. WBC count, PCT, CRP, TNF-α, GAS, and DAO were negatively correlated with the number of Bifidobacterium and Lactobacillus but positively correlated with E. coli. MOT, CIT, CD4+, and CD8+ were positively correlated with the number of Bifidobacterium and Lactobacillus but negatively correlated with E. coli. There was a negative correlation between Bifidobacterium and Lactobacillus and GIDF score and a positive correlation between E. coli and GIDF score. Therefore, the change in the intestinal microflora in elderly patients with sepsis is related to GIDF.
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