加味四君子汤联合红霉素治疗早产儿喂养不耐受临床疗效观察

Clinical observation of the effect of modified sijunzi decoction combined with erythromycin on feeding intolerance in premature infants

目的探讨加味四君子汤联合红霉素治疗早产儿喂养不耐受(feeding intolerance,FI)的临床疗效。方法选取自2013年6月至2015年8月期间,在我院新生儿病房住院并诊断为FI的早产儿80例,采用双盲、随机的方法将患儿分为对照组和观察组各40例,对照组患儿喂奶前予非营养性吸吮5min、红霉素口服(5mg/kg·次,12h 1次,治疗7d),观察组在对照组的基础上加用加味四君子汤进行治疗,治疗后比较两组患儿的FI持续时间、体重开始增长的日龄、达到全肠内喂养时间、住院时间及血清胃泌素(gastrin,GAS)、血浆胃动素(motilin,MOT)水平。结果观察组患儿FI持续时间、体重开始增长的日龄、达到全肠内喂养时间、住院时间显著缩短,且均小于对照组,差异有统计学意义(P<0.05);观察组患儿血清GAS、血浆MOT平均水平明显高于对照组,差异有统计学意义(P<0.05)。结论加味四君子汤益气健脾、消积导滞疗效确切,联合红霉素治疗早产儿喂养不耐受的疗效优于单用西药,可显著改善早产儿FI的症状,提高FI早产儿血清GAS及血浆MOT水平。

Objective To investigate the curative effect of modified sijunzi decoction（ MSJZD） combined with erythromycin on feeding intolerance（ FI） in premature infants. Methods From June 2013 period to August 2015,all the children were divided into control group 40 cases and observation group 40 cases by the method of double blind and random. In the control group children were fed with non nutritive sucking for 5 minutes before feeding,and 5mg / kg erythromycin was taken orally in the case of feeding intolerance. In the observation group children were treated with MSJZD. After the end of treatment,FI sustained time,weight beginning to grow,full enteral feeding time,hospitalization time,serum gastrin（ GAS） and plasma motilin（ MOT） level were compared and analyzed. Results In the observation group FI last time,weight beginning to increase on the age,full enteral feeding time,and length of hospital stay were significantly shorter,which were less than that of the control group（ P〈0. 05）. In the two groups after treatment for children serum GAS and plasma MOT average were compared. In the observation group,the serum GAS and plasma MOT average was significantly higher than that of the control group（ P〈0. 05）. Conclusion The MSJZD has a significant effect on the spleen deficiency syndrome. The effect of combined erythromycin on feeding intolerance in preterm infants is better than that of single use western medicine,which can significantly improve the symptoms of premature infants with FI and serum GAS and plasma MOT levels of FI in preterm infants. MSJZD is a safe and effective treatment,which is worth in clinical promotion and application.