鼻饲自拟复胃汤配合早期肠内营养对脑科重症患者胃肠功能及免疫功能的影响

Nasogastric self fuweitang with early enteral nutrition on brain in patients with severe gastrointestinal function and immune function

目的探讨鼻饲自拟复胃汤配合早期肠内营养对脑科重症患者胃肠功能及免疫功能的影响。方法脑科重症患者40例,随机分为2组,每组20例,2组患者在入院或术后48 h生命体征平稳且无肠内营养禁忌证时均开始鼻饲肠内营养混悬液肠内营养支持,中药组在此基础上同时由胃管注入自拟复胃汤200 mL,疗程为7 d。分别于治疗前和治疗后的7 d中观察2组患者胃肠功能障碍的发生情况(包括腹胀、便秘、腹泻、消化道出血、呕吐及反流等),并于治疗前、治疗第7天检测患者前白蛋白(PA)、白蛋白(ALB)、血红蛋白(Hb)及淋巴细胞百分比(LYM%)、免疫球蛋白(IgM、IgG、IgA),将以上各组结果进行比较分析。结果治疗7 d后,中药组营养指标PA、Hb、LYM%及免疫指标IgM、IgG、IgA水平均高于对照组,且胃肠道并发症发生率低,2组比较差异有统计学意义(P<0.05)。结论自拟复胃汤配合早期肠内营养支持治疗,对改善脑科重症患者的胃肠功能及免疫功能,减少并发症方面有重要意义。

Objective To investigate the nasogastric proposed self fuweitang with early enteral nutrition on the brain in patients with severe gastrointestinal function and immune function. Methods Forty cases of brain critically ill patients were randomly divided into 2 groups, two groups of patients hospitalized or 48 h after vital signs were stable and enteral nutrition contraindications nasogastric full enteral nutritional supported the Chinese Medicines Board on this basis at the same time by the gastric tube into the stomach to be self fuweitang 200 mL, treatment for 7 days. 7 days before treat-ment and after treatment, the observed statistics of the 2 groups of patients with gastrointestinal dysfunction （including bloating, constipation, diarrhea, gastrointestinal bleeding, vomiting and reflux）and treatment, treatment 7 days of detection of patients with prealbumin （PA）, albumin （ALB）, hemoglobin （Hb）, and the percentage of lymphocy- tes （LYM%）, immunog[obulin （[gM, IgG, IgA）, the above results of a comparative analysis. Results After 1 week of treatment, traditional chinese medicine group nutrition indicators PA, Hb, the percentage of LYM% and immune parameters IgM and IgG, IgA, water average were higher than that in the control group, and concurrent gastrointestinal disease had a low incidence, the difference was statistically significant （P〈0.05）. Conclusion Since the proposed self fuweitang with early enteral nutrition therapy, to improve the brain in patients with severe gastrointestinal function and immune function, reduce complications.