目的 观察枳实导滞丸联合奥美拉唑治疗脓毒症胃肠功能障碍的临床疗效。方法 选取2023年10月—2025年11月河北省中医院收治的120例脓毒症胃肠功能障碍患者，按照随机数字法将患者分为对照组和治疗组，每组各60例。对照组患者给予注射用奥美拉唑钠，40 mg/次用0.9%氯化钠250 mL稀释静滴，1次/d。治疗组在对照组的基础上给予枳实导滞丸，1丸/次，3次/d。两组用药7 d。观察两组的临床疗效，比较两组中医症状积分、急性胃肠损伤分级（AGI）、急性生理功能和慢性健康状况评分系统Ⅱ（APACHE II）、序贯器官功能衰竭评估（SOFA）评分、生理指标（胃潴留量、肠鸣音次数、腹内压）、胃泌素-17（GAS-17）、内毒素（ET）、脂肪酸结合蛋白（I-FABP）、乳酸（Lac）、C反应蛋白（CRP）、血清降钙素原（PCT）、白细胞介素-6（IL-6）、可溶性髓系细胞触发受体（sTREM-1）水平。结果 治疗后，治疗组总有效率（96.66%）显著高于对照组（85.00%，P＜0.05）。治疗后，两组脘腹痞胀积分、恶心呕吐积分、肢体倦怠积分、大便不通或黑便积分较同组治疗前显著降低（P＜0.05）；治疗后，与对照组对比，治疗组脘腹痞胀积分、恶心呕吐积分、肢体倦怠积分、大便不通或黑便积分均降低（P＜0.05）。治疗后，两组SOFA评分、APACHE II评分、AGI评分均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组SOFA评分、APACHE II评分、AGI评分均降低（P＜0.05）。治疗后，两组GAS-17显著升高，而ET、I-FABP、Lac水平降低（P＜0.05）；治疗后，与对照组对比，治疗组GAS-17水平升高，ET、I-FABP、Lac水平均降低（P＜0.05）。治疗后，两组患者血清IL-6、CRP、PCT、sTREM-1水平均显著降低（P＜0.05）；治疗后，治疗组IL-6、CRP、PCT、sTREM-1水平均低于对照组（P＜0.05）。治疗后，两组胃潴留量、腹内压均降低，肠鸣音次数升高（P＜0.05）；治疗后，治疗组胃潴留量、腹内压均显著低于对照组，肠鸣音次数高于对照组（P＜0.05）。结论 枳实导滞丸联合奥美拉唑协同治疗脓毒症胃肠功能障碍疗效确切，可减轻患者胃肠道功能损伤，降低机体炎症反应，减轻病情危重程度，值得借鉴与应用。

Objective To explore the clinical efficacy of Zhishi Daozhi Pills combined with omeprazole in treatment of gastrointestinal dysfunction in sepsis. Methods A total of 120 patients with gastrointestinal dysfunction in sepsis who were admitted to Hebei Provincial Hospital of Traditional Chinese Medicine from October 2023 to November 2025 were selected. These patients were divided into control group and the treatment group according to random number method, with 60 patients in each group. Patients in control group patients were iv Omeprazole Sodium for injection, 40 mg each time, diluted with 250 mL of 0.9% sodium chloride for intravenous infusion, once daily. Patients in treatment group were given Zhishi Daozhi Pills on basis of control group, 1 pill each time, 3 times daily. Both groups were administered the medication for 7 d. The clinical efficacy of two groups was observed, and the Chinese medicine symptom scores, AGI, APACHE II, SOFA, physiological indicators (gastric retention volume, bowel sounds frequency, intra-abdominal pressure), GAS-17, ET, I-FABP, Lac, CRP, PCT, IL-6, and sTREM-1 levels of two groups were compared. Results After treatment, the total effective rate of treatment group (96.66%) was significantly higher than that of control group (85.00%, P < 0.05). After treatment, the scores of abdominal distension and discomfort, nausea and vomiting, limb fatigue, and constipation or black stool in both groups were significantly lower than those before treatment in the same group (P < 0.05). After treatment, compared with control group, the scores of abdominal distension and discomfort, nausea and vomiting, limb fatigue, and constipation or black stool in the treatment group were all decreased (P < 0.05). After treatment, the SOFA score, APACHE II score, and AGI score of both groups were significantly reduced (P< 0.05). After treatment, compared with control group, the SOFA score, APACHE II score, and AGI score of treatment group were all decreased (P< 0.05). After treatment, the GAS-17 level of both groups significantly increased, but the levels of ET, I-FABP, and Lac decreased (P < 0.05). After treatment, compared with control group, the GAS-17 level of treatment group increased, and the levels of ET, I-FABP, and Lac were all decreased (P< 0.05). After treatment, the levels of serum IL-6, CRP, PCT, and sTREM-1 in both groups were significantly decreased (P < 0.05). After treatment, the levels of IL-6, CRP, PCT, and sTREM-1 in treatment group were lower than those in control group (P < 0.05). After treatment, the gastric retention volume and intra-abdominal pressure of both groups were decreased, and the number of bowel sounds increased (P < 0.05). After treatment, the gastric retention volume and intra-abdominal pressure of the treatment group were significantly lower than those of the control group, and the number of bowel sounds was higher than that of the control group (P < 0.05).Conclusion The combination therapy of Zhishi Daozhi Pills combined with omeprazole for treating gastrointestinal dysfunction in sepsis is highly effective, and can alleviate the damage to the patients' gastrointestinal function, reduce the body's inflammatory response, and lower the severity of the disease. This approach is worthy of being studied and applied.

河北省中医药管理局科研计划项目（2022062）；政府资助临床医学优秀人才培养项目（ZF2024158）