补中益气汤联合电针治疗脾虚型ICU获得性衰弱疗效观察

Effect of Buzhong Yiqi Decoction Combined with Electroacupuncture on ICU Acquired Weakness of Spleen Deficiency

目的:观察补中益气汤联合电针治疗脾虚型ICU获得性衰弱(ICU-AW)的临床疗效。方法:将70例ICU-AW患者随机分为对照组(35例,脱落2例)和观察组(35例,脱落1例)。两组均采用ICU常规基础治疗,观察组加用补中益气汤联合电针治疗,疗程2周,观察两组患者机械通气时间和ICU住院时间,治疗前后APACHEⅡ评分、MRC评分、BI评分及血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,并评估两组患者临床疗效。结果:观察组机械通气时间和ICU住院时间均低于对照组(P<0.01);治疗前,两组患者APACHEⅡ评分、MRC评分、BI评分及血清IL-1β、IL-6、TNF-α的水平差异无统计学意义(P>0.05);两组治疗后APACHEⅡ评分较治疗前降低(P<0.01),且观察组低于对照组(P<0.01);两组治疗后MRC评分和BI评分较治疗前升高(P<0.01),且观察组高于对照组(P<0.01);两组治疗后血清IL-1β、IL-6及TNF-α的水平较治疗前降低(P<0.01),且观察组低于对照组(P<0.01);观察组总有效率高于对照组(P<0.05)。结论:通过补中益气汤联合电针综合治疗,可使ICU-AW患者肌肉力量明显增强,缩短病程,降低血清炎性因子水平,改善日常生活自理能力。

Objective:To observe the clinical efficacy of Buzhong Yiqi decoction combined with electroacupuncture in the treatment of ICU-acquired weakness(ICU-AW)of spleen deficiency.Methods:70 patients with ICU-AW were randomly divided into control group(35 cases,2 cases dropped off)and observation group(35 cases,1 case dropped off).The observation group was treated with Buzhong Yiqi Decoction combined with electroacupuncture for 2 weeks.The mechanical ventilation time and ICU hospitalization time of the two groups were observed.Before and after treatment,APACHEⅡscore,MRC score,BI score and serum interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels were evaluated,and the clinical efficacy of the two groups was evaluated.Results:The mechanical ventilation time and ICU hospitalization time in the observation group were lower than those in the control group(P<0.01).Before treatment,there were no significant differences in APACHEⅡscore,MRC score,BI score and serum IL-1β,IL-6,TNF-αlevels between the two groups(P>0.05).Compared before treatment,the APACHEⅡscore after treatment was decreased in the two groups(P<0.01),and that in the observation group was lower than the control group(P<0.01).The MRC score and BI score after treatment were higher than those before treatment in the two groups(P<0.01),and those in the observation group were higher than the control group(P<0.01).After treatment,the levels of serum IL-1β,IL-6 and TNF-αin the two groups were lower than those before treatment(P<0.01),and those in the observation group were lower than the control group(P<0.01).The total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusion:Buzhong Yiqi decoction combined with electroacupuncture can significantly enhance muscle strength,shorten the course of disease,reduce serum inflammatory factors,and improve self-care ability of daily life in patients with ICU-AW.