目的：观察四逆汤穴位贴敷联合双歧杆菌三联活菌散治疗脓毒症胃肠功能障碍的临床疗效及对炎症因子、凝血功能的影响。方法：将105 例脓毒症胃肠功能障碍患者按随机数字表法分为对照组（52 例） 和观察组（53 例）。对照组给予双歧杆菌三联活菌散治疗，观察组给予四逆汤穴位贴敷联合双歧杆菌三联活菌散治疗。比较2 组临床疗效及治疗前后中医证候积分、血清炎症因子［超敏C-反应蛋白（hs-CRP）、白细胞介素-4 （IL-4）、白细胞介素-8 （IL-8） ］、凝血功能指标［凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）］。结果：观察组总有效率高于对照组（P＜0.05），临床疗效优于对照组（P＜0.05）。治疗后，2 组中医证候积分、hs-CRP、FIB 及IL-8 水平较治疗前降低（P＜0.05），IL-4、PT、APTT 升高（P＜0.05），观察组上述指标改善优于对照组（P＜0.05）。结论：四逆汤穴位贴敷联合双歧杆菌三联活菌散治疗脓毒症胃肠功能障碍，能有效降低患者炎症因子水平，改善凝血功能，临床疗效显著。
Abstract： Objective： To observe the clinical effect of point application with Sini Tang combined with live combined bifidobacterium， lactobacillus and enteroccus powder for gastrointestinal dysfunction in sepsis and its effect on inflammatory factors and coagulation function. Methods： A total of 105 cases of patients with gastrointestinal dysfunction in sepsis were divided into the control group and the observation group according to the random number table method，with 52 and 53 cases in each group respectively. The control group was treated with live combined bifidobacterium，lactobacillus and enteroccus powder，and the observation group was treated with point application with Sini Tang combined with Live combined Bifidobacterium， Lactobacillus and Enteroccus powder. The traditional Chinese medicine(TCM) syndrome scores， the inflammatory factors in serum including high- sensitivity C- reactive protein(hs- CRP)， interleukin-4(IL-4) and interleukin-8(IL-8)，and the indexes of coagulation function including prothrombin time(PT)，activated partial thromboplastin time(APTT) and fibrinogen(FIB)，as well as the clinical effects in the two groups were compared before and after treatment. Results： The total effective rate in the observation group was higher than that in the control group，and the clinical effect in the observation group was better than that in the control group(P ＜ 0.05). After treatment ， TCM syndrome scores and the levels of hs- CRP， FIB and IL- 8 in the two groups were decreased when compared with those before treatment(P＜0.05)，and the levels of IL- 4，PT and APTT were increased(P＜0.05)；the improvement of the above indexes in the observation group was better than that in the control group(P＜0.05). Conclusion： Point application with Sini Tang combined with live combined bifidobacterium，lactobacillus and enteroccus powder for gastrointestinal dysfunction in sepsis can effectively decrease the levels of inflammatory factors，and improve the coagulation function with a significant clinical effect.