香砂六君子汤加减联合肠内营养治疗危重病胃肠功能障碍临床研究

Clinical Study of Modified Xiangsha Liujunzi Tang Combined with Enteral Nutrition for Gastrointestinal Dysfunction in Critical Illness

目的:观察香砂六君子汤加减联合肠内营养治疗(脾胃虚弱型)危重病胃肠功能障碍的疗效。方法:将重症监护室(ICU)收治的(脾胃虚弱型)危重病患者103例按随机数字表法分为观察组53例与对照组50例,2组患者均接受血流动力学稳定、水电解质及酸碱平衡纠正,对照组在此基础上接受肠内营养支持治疗,观察组在对照组基础上接受香砂六君子汤加减治疗,连续治疗14 d后,检测2组胃动素(MLT)、降钙素原(PCT)、C-反应蛋白(CRP)水平,评估其胃肠功能评分和中医证候积分,并判断临床疗效。结果:治疗后,2组血浆MLT水平较治疗前上升,且观察组血浆MLT水平高于对照组,差异有统计学意义(P<0.05)。治疗后,2组胃肠功能评分较治疗前下降,且观察组胃肠功能评分低于对照组,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分与治疗前比较明显下降,且观察组中医证候积分低于对照组,差异有统计学意义(P<0.05)。治疗后,2组血清PCT、CRP水平较治疗前明显下降,且观察组血清PCT、CRP水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组临床疗效总有效率为96.23%,对照组临床疗效总有效率为72.00%,观察组临床疗效总有效率高于对照组,差异有统计学意义(P<0.05)。结论:针对危重病患者临床实施香砂六君子汤加减联合肠内营养支持治疗疗效满意,可有效缓解胃肠功能障碍,抑制相应炎症反应,改善临床症状,在危重病胃肠功能障碍临床治疗中具有重要价值。

Objective:To observe the clinical effect of modified Xiangsha Liujunzi tang combined with enteral nutrition forgastrointestinal dysfunction(spleen-stomach deficiency type)in critical illness.Methods:Divided 103 cases of patients with critical illness(spleen-stomach deficiency type)who were admitted and treated in intensive care unit(ICU)into the observation group and the control group according to random number table method,53 cases in the observation group and 50 cases in the control group.Both groups received hemodynamic stabilization and water,electrolyte and acid-base balancing;the control group received enteral nutrition support therapy,while the observation group additionally received modified Xiangsha Liujunzi tang.After 14 days of continuous treatment,detected the levels of motilin(MLT),procalcitonin(PCT)and C-reactive protein(CRP)in both groups,evaluated the scores of gastrointestinal function and Chinese medicine syndrome scores,and evaluated the clinical effect.Results:After treatment,the levels of plasma MLT in both groups were higher than those before treatment,and the level of plasma MLT in the observation group was higher than that in the control group,difference being significant(P<0.05).After treatment,the scores of gastrointestinal function in both groups were lower than those before treatment,and the scores of gastrointestinal function in the observation group were lower than those in the control group,difference being significant(P<0.05).After treatment,Chinese medicine syndrome scores in both groups were evidently lower than those before treatment,and Chinese medicine syndrome scores of the observation group were lower than those in the control group,difference being significant(P<0.05).After treatment,the levels of serum PCT and CRP in both groups were evidently lower than those before treatment,and the levels of serum PCT and CRP in the observation group were evidently lower than those in the control group(P<0.05).After treatment,the total effective rate was 96.23%in the observation group,being higher than 72.00%in the control group,difference being significant(P<0.05).Conclusion:The application of modified Xiangsha Liujunzi tang combined with enteral nutrition support therapy has satisfying curative effect in treating patients with critical illness.It can effectively relieve gastrointestinal dysfunction,inhibit relevant inflammatory reactions and improve clinical symptoms,which shows significant value in the clinical treatment of gastrointestinal dysfunction in critical illness.