肝胃百合汤对脑卒中后肠内营养患者胃肠道并发症及神经功能评分的影响

Influence of Ganwei Baihe Decoction on Gastrointestinal Tract Complications and Neurological Deficit Scores in Post-Stroke Patients with Enteral Nutrition

目的:观察肝胃百合汤对脑卒中后肠内营养患者胃肠道并发症及神经功能评分的影响。方法:将160例卒中后48 h内接受肠内营养治疗的患者为研究对象随机分为对照组、益气健脾组、祛湿组、从肝论治组,每组40例。对照组患者于入院48 h内留置鼻胃管,实施肠内营养支持治疗,益气健脾组在对照组治疗的基础上给予四君子汤治疗,祛湿组在对照组治疗的基础上给予藿香正气散治疗,从肝论治组在对照组治疗的基础上给予肝胃百合汤治疗,四组患者均连续治疗28 d。比较各组患者胃肠道并发症发生率,对患者神经功能(GCS评分和NIHSS评分)进行评分。结果:从肝论治组胃潴留发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组反流发生率低于对照组和益气健脾组(P<0.05),也低于祛湿组,但差异无统计学意义(P>0.05)。从肝论治组呕吐发生率低于对照组(P<0.05),也低于益气健脾组和祛湿组,但差异无统计学意义(P>0.05)。从肝论治组腹胀发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组便秘发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组腹泻发生率低于对照组(P<0.05),也低于益气健脾组和祛湿组,但差异无统计学意义(P>0.05)。从肝论治组胃肠道出血发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组治疗后第28天GCS评分和NIHSS评分优于对照组、益气健脾组、祛湿组(P<0.05)。结论:脑卒中后肠内营养患者给予肝胃百合汤治疗,有助于改善患者神经功能,减少胃肠道并发症的发生率。

Objective：To observe the influence of Ganwei Baihe Decoction on gastrointestinal tract complications and neurological deficit scores in post-stroke patients with enteral nutrition. Methods ：Totally 160 post-stroke patients with enteral nutrition within 48 h were randomized into control group, qi-benefiting and spleen-strengthening group, damp-removing group, treatment of the liver group,40 cases in each group. Control group were given enteral nutrition support therapy within 48 h;qi-benefiting and spleen- strengthening group were additionally given Four Gentlemen Decoction;damp-removing group were given Agastache Qi-Correeting Powder on the basis of control group;treatment of the liver group were additionally given Ganwei Baihe Decoction on the basis of control group ,28d of continuous treatment for four groups. The occurrence rates of gastrointestinal tract complications in the four groups were compared. The GCS and NIHSS of nerve function were scored. Results ： The occurrence rate of gastric retention in treatment of the liver group was lower than the other three groups （ P 〈 0.05）. The occurrence rate of reflux in treatment of the liver group was lower than that in control group and qi-benefiting and spleen-strengthening group （ P 〈 0. 05 ） and also lower than that in damp-removing group, but the difference had no statistical significance （ P 〉 0. 05 ）. The occurrence rate of vomiting in treatment of the liver group was lower than that in control group （ P 〈 0.05 ）, and ＇also lower than the other two groups, but the difference had no statistical significance （ P 〉 0.05 ）. The occurrence rates of abdominal distension, constipation and gastrointesti- nal bleeding in treatment of the liver group were lower than those in other three groups （ P 〈 0.05 ）. The occurrence rate of diar- rhea in treatment of the liver group was lower than that in control group （ P 〈 0. 05 ） , and also lower than the other two groups, but the difference had no statistical significance （ P 〉 0.05 ）. The scores of GCS and NIHSS 28 days alter treatment in treatment of the liver group were superior to those in the other three groups （ P 〈 0.05 ）. Conclusion ： For post-stroke patients with enteral nutri- tion,Ganwei Baihe Decoction can improve the nerve function and reduce the occurrence rate of gastrointestinal tract complica- tions.