<?xml version="1.1" encoding="utf-8"?>
<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">MRP</journal-id><journal-title-group><journal-title>Medical Research and Practice</journal-title></journal-title-group><issn>2993-9690</issn><eissn>2993-9704</eissn><publisher><publisher-name>Art and Design</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.61369/MRP.2025120029</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>参苓白术散治疗危重症患者胃肠功能障碍的临床疗效观察</title><url>https://artdesignp.com/journal/MRP/3/12/10.61369/MRP.2025120029</url><author>赵彦萍,王晓旭,刘霞</author><pub-date pub-type="publication-year"><year>2025</year></pub-date><volume>3</volume><issue>12</issue><history><date date-type="pub"><published-time>2025-12-20</published-time></date></history><abstract>目的 探讨参苓白术散对危重症患者胃肠功能及免疫球蛋白、T淋巴细胞亚群、细胞因子的影响。方法 选取2023年6月1日至2025年8月30日收治的84例胃肠功能障碍危重症患者，随机分为治疗组（27例）、对照1组（30例）和对照2组（27例）。治疗组采用西医常规治疗联合参苓白术散，对照1组仅用西医常规治疗，对照2组仅用参苓白术散。疗程均为7天。比较三组治疗前后AGI分级、免疫球蛋白（IgA、IgG、IgM）、T淋巴细胞亚群（CD3+、CD4+/CD8+）、细胞因子（TNF-&amp;alpha;、IL-6）及补体C3、C4水平。结果 治疗组AGI分级改善显著，显效率达59.3%，总有效率88.9%，优于两对照组（P＜ 0.05）。治疗组TNF-&amp;alpha;、IL-6水平下降更明显（P＜ 0.05），IgA、IgG、IgM、CD3+、C3、C4水平显著上升（P＜ 0.05）。CD4+/CD8+比值在三组间无显著变化（P＞0.05）。三组均未出现明显不良反应。结论 参苓白术散可有效改善危重症患者胃肠功能，减轻炎症反应，增强免疫功能，安全性良好。</abstract><keywords>参苓白术散,中医药治疗,危重症,免疫,炎性因子</keywords></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>[1]Reintam Blaser A, Poeze M, Malbrain ML, Bj&amp;ouml;rck M, Oudemans-van Straaten HM, Starkopf J. Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study. Intensive Care Med. 2013. 39(5): 899-909.[2]De Backer D, Creteur J, Preiser JC, Dubois MJ, Vincent JL. Microvascular blood flow is altered in patients with sepsis. Am J Respir Crit Care Med. 2002. 166(1): 98-104.[3]Morelli A, Passariello M. Hemodynamic coherence in sepsis. Best Pract Res Clin Anaesthesiol. 2016. 30(4): 453-463.[4]Deitch EA. Bacterial translocation or lymphatic drainage of toxic products from the gut: what is important in human beings. Surgery. 2002. 131(3): 241-4.[5]上海市中西医结合学会急救专业委员会, 上海市中西医结合学会重症医学专业委员会, 上海市医师协会急诊科医师分会等. 脓毒症急性胃肠功能障碍中西医结合临床专家共识. 中华危重病急救医学. 2022. 34(2): 8.[6]Reintam Blaser A, Preiser JC, Fruhwald S, et al. Gastrointestinal dysfunction in the critically ill: a systematic scoping review and research agenda proposed by the Section of Metabolism, Endocrinology and Nutrition of the European Society of Intensive Care Medicine. Crit Care. 2020. 24(1): 224.[7]Liu X, Wang Q, Yang D, et al. Association between Gastrointestinal Dysfunction Score (GIDS) and disease severity and prognosis in critically ill patients: A prospective, observational study. Clin Nutr. 2023. 42(5): 700-705.[8]于佳琪, 梁群, 刘雨默, 刘洋, 李鹤然. 中医药治疗脓毒症胃肠功能障碍的研究进展[J].中国中医急症. 2023. 32(3): 545-547.[9]张羽, 陈腾飞, 张鑫等. 刘清泉运用温涩法治疗危重症患者胃肠功能障碍经验[J].北京中医药. 2023. 42(03): 288-290.[10]许梦婷. 五达颗粒治疗危重症胃肠功能障碍（脾虚气滞证）的临床研究. 见:李健,主编. (03) ,2022.[11]张佩芝, 王慧, 李平海, 李正光, 王惠莹. 参苓白术散对老年多器官功能不全合并营养不良患者营养状况及免疫功能的影响[J].贵州医科大学学报. 2022. 47(11): 1339-1343+1348.[12]衣凯. 参苓白术散对气血两虚结直肠癌术后患者胃肠功能的临床疗效观察. 见:许斌,主编. (03) ,2023.[13]汪舒云, 谢曼丽, 孙可向, 邓皖利. 参苓白术散对大肠癌移植瘤模型小鼠化学疗法后肠道黏膜屏障的影响[J].上海中医药杂志. 2023. 57(04): 57-64.[14]Lai YH, Wu TC, Tsai BY, et al. Peroxisome proliferator-activated receptor-&amp;gamma; as the gatekeeper of tight junction in Clostridioides difficile infection. Front Microbiol. 2022. 13: 986457.[15]朱云飞, 刘传国, 赵楠, 刘慧敏. 基于miR-130a/PPAR&amp;gamma;/Occludin信号通路的参苓白术散对溃疡性结肠炎小鼠肠道屏障功能影响的探究[J].时珍国医国药. : 1-7.[16]Greis C, Rasuly Z, Janosi RA, Kordelas L, Beelen DW, Liebregts T. Intestinal T lymphocyte homing is associated with gastric emptying and epithelial barrier function in critically ill: a prospective observational study. Crit Care. 2017. 21(1): 70.[17]王梅, 武英茹, 王越欣等. 不同米炒党参对脾虚大鼠胃肠道功能、免疫功能、水液代谢的影响[J].中药材. 2021. 44(11): 2566-2570.[18]邓鹏, 徐驲, 刘言薇, 胡芳, 刘中勇. 茯苓水提物对环磷酰胺荷瘤小鼠免疫微环境的影响[J].中国全科医学. 2021. 24(S2): 28-30.[19]江勇, 朱大侠, 刘礼剑. 白术多糖通过调控TLR4/NF-&amp;kappa;B信号通路对重症急性胰腺炎大鼠肠黏膜免疫屏障的影响[J].中成药. 2021. 43(03): 624-629.[20]Ma H, Tao W, Zhu S. T lymphocytes in the intestinal mucosa: defense and tolerance. Cell Mol Immunol. 2019. 16(3): 216-224.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
