陈夏四君子汤促进重症患者胃肠功能恢复的临床疗效观察

Clinical observation of the role of Chenxia Sijunzi decoction in promoting the recovery of gastrointestinal function in critically ill patients

目的观察陈夏四君子汤对重症患者促进胃肠功能恢复的临床疗效。方法采用前瞻性随机对照研究方法，将2011年9月至2012年3月四川省泸州市人民医院重症医学科需肠内营养的80例重症患者按随机数字表法分为3组，中药组、西药组各35例，对照组10例。对照组给予常规对症治疗，同时协助患者下肢活动、勤翻身，不采用任何促胃肠动力药物，让患者肠道功能自行恢复；在对照组治疗基础上，中药组管喂陈夏四君子汤；西药组管喂多酶片及莫沙必利分散片治疗。观察患者肠鸣音恢复时间、排气时间、排便时间以及住院时间。结果中药组、西药组肠鸣音恢复时间（h：41．02±7．52、44．02±6．23）、肛门排气时间（h：49．90±6．95、51．32±5．12）、排便时间（h：58．22±6．71、60．91±3．72）均较对照组（54．62±5．51、64．68±9．47、78．20±7．11）明显提前（均P〈0．01），住院时间（d：5．1±1．7、5．0±1．5）较对照组（8．9±1．4）明显缩短（均P〈0．01）；而中药组与西药组各指标比较差异均无统计学意义（均19〉0．05）。结论陈夏四君子汤能够促进重症患者的胃肠功能恢复，缩短住院时间。

Objective To observe the clinical effects of Chenxia Sijunzi decoction on promoting gastroentestinal function recovery in severe patients. Methods A prospective randomized controlled study was conducted. Eighty severe patients feeding with enteral nutrition from September 2011 to March 2012 were divided into three groups according to the method of random number table. The traditional Chinese medicine group and western medicine group were consisted of 35 cases respectively, and 10 cases were control group. Control group was routine symptomaticly treated without any medicines for promoting gastroentestinal power function, helping the lower extremities to move and enhancing the turn over, letting the gastrointestinal function recover by its self. Chinese medicine group was tube feeded with Chenxia Sijunzi decoction on the basis of control group, western medicine group was tube feeded with the muhienzyme tablets and mosapride dispersible tablets on the basis of control group. Then the differences in bowel sound recovery time and the time for passage of gas by anus and the bowel movement time and length of stay in hospitals within three groups were observed. Results The time of bowel sound recovery （hours：41.02 ± 7.52, 44.02 ± 6.23 ）, gas passage time by anus （hours：49.90 ± 6.95, 51.32 ± 5.12） and the bowel movement time （hours：58.22 ± 6.71, 60.91 ± 3.72 ） in both traditional Chinese medicine and the western medicine group were significantly reduced compared with the control group （54.62 ± 5.5 1 64.68 ± 9.47, 78.20 ± 7.11, all P〈0.01 ）, and the days in hospital （days ： 5.1 ± 1.7, 5.0 ± 1.5） were shortened significantly compared with the control group （8.9 ± 1.4, both P〈0.01）. However, results did not demonstrate any significant differences in each testing index between traditional Chinese medicine and western medicine group （all P 〉0.05）. Conclusion Chenxia Sijunzi decoction can promote severe patient＇s gastrointestinal function recovery and reduce hospitalization days.