六君子汤合当归补血汤加减联合肠内营养治疗ICU老年肺部感染的临床疗效观察

Clinical Efficacy of Liujunzi Decoction and Modified Danggui Buxue Decoction Combined with Enteral Nutrition in the Treatment of Elderly Pulmonary Infection in ICU

目的探究六君子汤合当归补血汤加减联合肠内营养治疗重症监护室(Intensive Care Unit,ICU)老年肺部感染的临床疗效观察。方法选取2016年11月—2019年11月期间北京市大兴区中西医结合医院ICU老年肺部感染患者106例,根据随机数字表法分为治疗组和对照组,每组各53例。对照组给予肠内营养,治疗组在对照组基础上加用六君子汤合当归补血汤加减。两组均治疗10 d,观察两组中医证候积分、临床疗效、营养状态、肠内营养并发症情况。结果治疗后两组患者中医证候积分与治疗前比较均降低(P<0.05),且治疗组治疗后中医证候积分低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后治疗组总有效率94.34%(50/53)明显高于对照组79.25%(42/53),两组比较差异有统计学意义(P<0.05)。治疗后两组患者白蛋白(Albumin,ALB)、前白蛋白(Prealbumin,PA)、血红蛋白(Hemoglobin,Hb)水平及三角肌皮褶厚度与治疗前比较均改善(P<0.05),且治疗组治疗后ALB、PA水平高于对照组,两组比较差异有统计学意义(P<0.05)。治疗期间治疗组患者胃潴留、腹泻、消化道应激性溃疡发生率7.55%(4/53)明显低于对照组患者22.64%(12/53),两组比较差异有统计学意义(P<0.05)。结论六君子汤合当归补血汤加减联合肠内营养可提高老年肺部感染肠内营养治疗的效果,改善患者营养状况,并能减少肠内营养的并发症,具有临床推广意义。

Objective To explore the clinical efficacy of Liujunzi Decoction,modified Danggui Buxue Decoction combined with enteral nutrition in elderly ICU patients with pulmonary infection in the Intensive Care Unit(ICU).Methods From November 2016 to November 2019,106 elderly patients with lung infection in the ICU of Beijing Daxing District Hospital of Integrated Traditional Chinese and Western Medicine were selected and divided into treatment group and control group according to the random number table method,with 53 cases in each group.The control group was given enteral nutrition,and the treatment group added Liujunzi Decoction and Danggui Buxue Decoction on the basis of the control group.Both groups were treated for 10 days,and the scores of TCM syndromes,clinical efficacy,nutritional status,and complications of enteral nutrition were observed.Results After treatment,the TCM syndrome scores of the two groups of patients were lower than before treatment(P<0.05),and the TCM syndrome scores of the treatment group after treatment were lower than those of the control group,the difference was statistically significant(P<0.05).After treatment,the total effective rate of the treatment group was 94.34%(50/53)was significantly higher than that of the control group 79.25%(42/53),and the difference between the two groups was statistically significant(P<0.05).After treatment,the albumin(Albumin,ALB),prealbumin(PA),hemoglobin(Hb)levels and deltoid skinfold thickness of the two groups were improved compared with those before treatment(P<0.05),and the treatment group After treatment,the levels of ALB and PA were higher than those of the control group,and the difference between the two groups was statistically significant(P<0.05).During the treatment period,the incidence of gastric retention,diarrhea,and gastrointestinal stress ulcer in the treatment group was 7.55%(4/53)significantly lower than that of 22.64%(12/53)in the control group.The difference between the two groups was statistically significant(P<0.05).Conclusions The Liujunzi Decoction and modified Danggui Buxue decoction combined with enteral nutrition can improve the effect of enteral nutrition therapy,improve the nutritional status,and reduce the complications of enteral nutrition in elderly patients with pulmonary infection.