中药小剂量多次给药促进危重症肠功能恢复的临床研究

Clinical study on the intestinal functional recovery of critical disease treated with the small-dose and repeated-use of Chinese herbal medicine

目的观察中药汤剂小剂量多次给药与常规剂量给药方式在促进危重症患者胃肠道功能恢复的临床疗效。方法将存在胃肠功能障碍的危重症患者60例,随机分为小剂量组(实验组)及常规剂量组(对照组),各30例。每组患者均予治疗原发病、生命支持治疗,辨证论治给予中药,经鼻饲管鼻饲给药。实验组予汤药浓煎100ml/d,分5次鼻饲,20 ml/次。对照组予汤药140 ml/次,2次/d,鼻饲。观察两组治疗后有效率、肠功能恢复时间、腹内压(IAP)、肠鸣音、排便次数情况。结果两组患者治疗后,实验组总有效率为93.3%,对照组为80.00%,两组比较差异有统计学意义(P<0.05)。实验组患者肠功能恢复时间明显优于对照组(P<0.05)。两组患者治疗后IAP、肠鸣音、排便次数均较治疗前有所改善(P<0.05),两组治疗后各指标比较,差异无统计学意义(P>0.05)。结论中药汤剂浓煎小剂量多次给药与常规剂量给药相比可以更快促进危重症患者肠功能的恢复。

Objective To observe the clinical effects on the intestinal functional recovery of critical disease treated with the small-dose and repeated-use of Chinese herbal medicine and routine medication. Methods A total of 60 patients of critical disease with gastrointestinal dysfunction were randomized into a small-dose group(experiment group）and a routine-dose group(control group）,30 cases in each one. In both groups,the treatment for primary disease,life supporting therapy,Chinese herbal medicine based on TCM differentiation and nasal medication were applied. In the experiment group,the high-concentrated Chinese herbal medicine,100 ml/d was given,5 times of nasal feeding,20 ml each time. In the control group,the Chinese herbal decoction was used,140 ml each time,twice a day,with nasal feeding. The effective rate,the time of intestinal functional recovery,intra-abdominal pressure,bowel sound and defecating frequency were observed in the two groups after treatment. Results After treatment,the total effective rate was 93. 3% in the experiment group and was 80. 00% in the control group,indicating the significant difference in comparison(P〈 0. 05）. In the experiment group,the recovery time of the intestinal function was better remarkably than the control group(P〈 0. 05）. After treatment,the intra-abdominal pressure,bowel sound and defecating frequency were all improved as compared with those before treatment in the two groups(P〈 0. 05）. The difference was not significant in each index between the two groups after treatment(P〉 0. 05）. Conclusion The Chinese herbal decoction of high concentration,small dosage and repeated use promotes more effectively the recovery of the intestinal function in the patients of critical disease as compared with the medication of routine dosage.