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Effect of Rhubarb on Gastrointestinal Dysfunction in critically III patients： A Retrospective Study Based on Propensity Score Matching

引用

Chinese Medical Journal 2018年第10期131卷 1142-1150页

作者： Xian Zhang Lyu Wang De-Chang Chen Department of Emergency Medicine Changzheng Hospital The Second Military Medical University Shanghai 200003 China

Background： Gastrointestinal dysfunction plays a critical role in the prognosis of critically ill patients. Previous studies showed rhubarb, a traditional Chinese herb, can protect the intestinal barrier function, prevent intestinal bacterial translocation, and promote gastrointestinal peristalsis, but the clinical studies are less. The aim of this study was to evaluate the effects of rhubarb on gastrointestinal dysfunction in critically ill patients. Methods： From June 2015 to May 2017, a total of 368 critically ill patients with Grade I III acute gastrointestinal injury （AGI） were enrolled in this study. patients were divided into two groups according to the exposure factors （whether the patients received rhubarb treatment）： the rhubarb group and the usual treatment group. Clinical data were collected within the first 24 h of the Intensive Care Unit （ICU） admission and 7 days after treatment. Survival data on day 28 after ICU admission and the durations oflCU and total hospitalization were also collected. Propensity score matching （PSM） was conducted to reduce confounding bias between the groups. The logistic regression was conducted to screen the influence factors. Results： The eligible patients were divided into rhubarb group （n = 219, 59.5%） and usual treatment group （n = 149, 40.5%）. Betbre PSM, the remission rate of feeding intolerance in rhubarb group and usual treatment group were 59.8% and 39.6%, respectively. After PSM, the remission rate of feeding intolerance in rhubarb group and usual treatment group was 77.9% and 30.9%, respectively. The remission rates of feeding intolerance in rhubarb group were significantly higher than those in the usual treatment group （all P 〈 0.05）. Compared with the usual treatment group, the rhubarb group had a higher rate of AGI improvement, lower level of C-reactive protein, shorter stay in ICU before and after PSM （P 〈 0.05）. There was no significant difference in 28-day mortality between rhubarb and usual treatment groups before and after PSM （48 vs. 33, P 0.959; and 1

关键词： critically 111 patients Gastrointestinal Dysfunction Propensity Score Matching Rhubarb

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