益气健脾法用于危重症患者营养障碍的临床研究

The method of replenishing Qi to invigorate spleen treats the patients of severe cases withmalnutrition

目的观察益气健脾法（四君子汤）联合肠内营养剂治疗危重症患者营养障碍的疗效。方法回顾性分析2010年1月至2011年11月青岛市海慈医疗集团重症医学科收治的100例危重症患者，按病例尾号随机分为两组各50例。对照组采用能全力以肠内营养泵匀速滴注治疗，试验组在对照组治疗基础上加用四君子汤治疗。两组患者分别于治疗前、治疗后5d、10d检测总蛋白、白蛋白、前白蛋白、血红蛋白等营养学指标。结果对照组在治疗后10d总蛋白、白蛋白和前白蛋白均有增长趋势，但差异无统计学意义（P〉0．05）；试验组总蛋白和白蛋白在治疗后5d[分别为（58．20±3．62）g、（30．42±3．06）g]及10d[分别为（65．04±3．74）g、（34．26±3．07）g]时，较同组治疗前[分别为（56．18±4．57）g、（29．20±2．53）g]升高（P〈0．05）；前白蛋白治疗后10d（268．50±54．3）g与对照组（98．82±7．15）g比较明显增长（P〈0．05）。结论常规肠内营养联合中益气健脾法可改善危重症患者营养不良状况。

Objective To explore the method of replenishing qi to invigorate spleen combined with enteral nutrition therapy in the treatment of patients with severe cases and malnutrition. Methods Reviewed 100 cases of critically patients with severe cases who came from the intensive care unit （ICU） of Qingdao Hiser Hospital from January of 2010 to November of 2011. According to the unified criteria of patients selection, we randomly divided them into two groups, namely, a control group, who received enteral nutrition only, and an experiment group, who received enteral nutrition combined with the traditional Chinese medicine to replenish qi and invigorate spleen. Detecting the nutritional markers as follows in two groups on the first day before the nourishment therapy, on the fifth day and the tenth day after treatment, which were Total protein（TP）, Albumin （ALB）, Preabumin （PA）, Hemoglobin （HB）. Results No matter five days or ten days after the treatment, the nutrition markers such as PA, TP and ALB of the control group had the tendency to increase, but no statisticatly significance （P〉0.05） , The experiment group had improved such markers as ALB and TP after five days [ （58.20±3.62） g, （30.42 ± 3.06） g] and ten days [ （65.04± 3.74） g, （34.26 ±3.07） g] significantly（P〈0.05 ）. The experiment group had improved significantly such markers as PA after ten days （268.50± 54.3） g, （P〈0.05） . Conclusion We consider using enteral nutrition only is not clear to improve malnutrition, however, using the Chinese medicine of replenishing qi to invigorate spleen therapy combined with enteral nutrition can improve malnutrition.