健脾消糖颗粒对机械通气伴应激性高血糖患者临床疗效的影响

Clinical effect of Jianpi Xiaotang granule on mechanical ventilated patients with stress hyperglycemia

目的观察健脾消糖颗粒对机械通气伴应激性高血糖患者临床疗效的影响。方法选取2013年3月至2016年9月在德清县人民医院重症医学科接受治疗的88例机械通气伴应激性高血糖患者，将患者按计算机产生的随机数分为观察组和对照组，每组44例。两组患者均应用胰岛素泵进行治疗，观察组在胰岛素泵等常规治疗基础上加用健脾消糖颗粒（组成：黄芪2袋，淮山药1袋，柴胡1袋，郁金1袋，鬼箭羽1袋，泽泻1袋，黄精2袋，葛根1袋，黄连1袋，何首乌1袋，每袋颗粒剂相当于原生药10g）每次1包，每日2次。比较两组患者的临床相关指标、胰岛素用量、胰岛素使用时间、机械通气时间和低血糖、感染等不良反应发生率的差异。结果观察组患者胰岛素用量（U／d：25±6比42±8）、胰岛素使用时间（d：8±3比12±5）、机械通气时间（d：10±4比14±6）及不良反应低血糖发生率[6．8％（3／44）比22．7％（10／44）]、感染发生率[4．5％（2／44）比20．5％（9／44）]均较对照组显著降低（均P〈0．05）。结论健脾消糖颗粒能减少机械通气伴应激性高血糖患者的胰岛素用量，缩短胰岛素使用时间，降低低血糖发生率，同时能减少感染的发生，缩短机械通气时间。

Objective To analyze the clinical effects of Jianpi Xiaotang granule on mechanical ventilated （MV） patients with stress hyperglycemia. Methods A total of 88 MV patients with stress hyperglycemia admitted to Department of Critical Care Medicine of Deqing People＇s Hospital from March 2013 to September 2016 were enrolled, and they were divided into an observation group and a control group according to the random digital table method, each group 44 cases. All the patients were given insulin pump therapy, the observation group additionally received Jianpi Xiaotang granule （constituent： astragalus 2 bags, rhizoma dioscorea 1 bag, radix bupleuri 1 bag, radix cureumae 1 bag, ramuli euonymi l bag, rhizoma alismatis 1 bag, rhizoma polygonati 2 bags, puerarin 1 bag, eoptis chinensis 1 bag, polygonum muhiflorum 1 bag, each bag of granule is equivalent to the original medicine 10 g） one dose a day, 1/2 dose twice a day administered with water orally. The differences in clinically related indexes, insulin dosage, insulin treatment period, MV time, and in the incidences of adverse reactions, such as hypoglycemia and infection were compared between the two groups. Results The insulin dosage （U/d： 25 ± 6 vs. 42± 8）, insulin treatment period （days： 8 ± 3 vs. 12±5）, MV time （days： 10±4 vs. 14 ± 6）, the incidences of adverse reactions of hypoglycemia [6.8% （3/44） vs. 22.7% （10/44）] and infection [4.5% （2/44） vs. 20.5% （9/44）] in the observation group were significantly lower than those in the control group （all P 〈 0.05）. Conclusion Jianpi Xiaotang granule can reduce the close of insulin, shorten the periods of insulin treatment and MV, and decrease the risk of incidences of hypoglycemia and infection in MV patients with stress hyperglycemia.