健脾温阳法治疗老年肺脾气虚型肺炎后胃肠功能紊乱临床观察

Curative effect of Jianpi Wenyang Chinese medicine for elderly pneumonia patients with intestinal dysfunction of lung spleen-deficiency type

目的观察健脾温阳法治疗老年肺脾气虚型肺炎后胃肠功能紊乱的临床疗效。方法将80例老年肺脾气虚型肺炎后胃肠功能紊乱住院患者按照随机数字表法分为2组,对照组40例予西医常规治疗,治疗组40例在对照组基础上加用健脾温阳中药治疗。2组均治疗14天后统计疗效,比较2组治疗前后中医症状(包括咳嗽气短、脘腹胀痛、食少纳呆、恶心呕吐、体倦乏力、排便秘结或泄泻)评分、急性生理和慢性健康状况Ⅱ评分(APACHEⅡ)评分、简明健康状况调查表(SF-36)评分、血清生化指标[胃动素(MLT)、胃泌素(GAS)、前白蛋白(PA)、二胺氧化酶(DAO)、胃肠D-乳酸(D-LA)及白蛋白(ALB)水平)]水平变化情况。结果治疗组总有效率92.50%(37/40),对照组总有效率75.00%(30/40),治疗组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状咳嗽气短、脘腹胀痛、食少纳呆、恶心呕吐、体倦乏力、排便秘结或泄泻评分均降低(P<0.05),且治疗组治疗后中医症状咳嗽气短、脘腹胀痛、食少纳呆、恶心呕吐、体倦乏力、排便秘结或泄泻评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后APACHEⅡ评分均降低(P<0.05),SF-36评分均升高(P<0.05),且治疗组治疗后APACHEⅡ评分低于对照组(P<0.05),SF-36评分高于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清MLT、PA、ALB水平均升高(P<0.05),GAS、DAO、D-LA水平均降低(P<0.05),且治疗组治疗后血清MLT、PA、ALB水平均高于对照组(P<0.05),GAS、DAO、D-LA水平均低于对照组(P<0.05)。结论健脾温阳法治疗老年肺脾气虚型肺炎后胃肠功能紊乱疗效显著,可有效改善患者中医症状,促进炎症消退,调节胃肠激素水平,促进胃肠蠕动,保护和修复肠黏膜屏障,从而改善胃肠功能和营养状态,提高生活质量。

Objective To explore the curative effect of Jianpi Wenyang Chinese medicine for elderly patients with intestinal dysfunction of lung spleen-deficiency type after pneumonia.Methods A total of 80 elderly pneumonia patients with intestinal dysfunction of lung spleen-deficiency type who was admitted to our hospital were randomly assigned into the treatment group(n=40)and the control group(n=40).All patients were managed by routine Western medicine,and those in the treatment group were additionally treated with Jianpi Wenyang Chinese medicine.A 14-day treatment was performed to compare curative effect,traditional Chinese medicine(TCM)(cough shortness of breath,abdominal pain,poor appetite,nausea and vomiting,fatigue,constipation or diarrhea)symptom score,Acute Physiology and Chronic Health Evaluation II(APACHE II)scores,36-item Short Form Health Survey(SF-36),serum biochemical indexes(Motilin[MLT],gastrin[GAS],prealbumin[PA],diamine oxidase[DAO],D-lactic acid[D-LA],Albumin[ALB]).Results The total effective rate in the treatment group was higher than that in the control group(92.50%[37/40]vs 75.00%[30/40],P<0.05).After treatment,TCM symptom scores in the two groups were decreased(P<0.05),the treatment group was more common(P<0.05).Decreased APACHEⅡscores and increased SF-36 scores were detected in the two groups than those before treatment(all P<0.05),and the different was significant between groups for the above indexes(both P<0.05).Elevated MLT,PA,ALB levels and reduced GAS,DAO,D-LA levels were detected in groups(all P<0.05),and the different was significant between groups(all P<0.05).Conclusion For elderly pneumonia patients with intestinal dysfunction of lung spleen-deficiency type,Jianpi Wenyang Chinese medicine has significant curative effect,which can effectively improve TCM symptoms,promote the resolution of inflammation,regulate gastrointestinal hormones,promote gastrointestinal peristalsis,protect and repair the intestinal mucosal barrier,thereby improving gastrointestinal function and nutritional status,and the quality of life.