黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者ICU获得性衰弱的疗效

Effect of Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤)Combined with Acupuncture on ICU Acquired Weakness in Patients with Severe Bone Trauma

目的观察黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者重症监护病房(intensive care unit,ICU)获得性衰弱的效果。方法将66例重症骨创伤ICU获得性衰弱患者,按照随机数字表法分为对照组33例和观察组33例。对照组给予功能锻炼,观察组在此基础上联合黄芪桂枝五物汤加减联合针刺,连续治疗2周。比较两组的临床疗效、机械通气时间、ICU住院天数、日常生活活动能力Barthel指数(BI)评分、APACHEⅡ评分、肌力状态(MRC)评分。结果观察组的有效率90.91%(30/33),高于对照组的有效率69.70%(23/33)(P<0.05);观察组机械通气天数、住ICU时间明显短于对照组(P<0.05);治疗14d,观察组患者的BI等级优于对照组(P<0.05);治疗3d、治疗5d、治疗7d的观察组的APACHEⅡ评分明显低于对照组,肌力状态MRC评分明显高于对照组(P<0.05)。结论黄芪桂枝五物汤加减联合针刺治疗能明显缩短重症骨创伤ICU获得性衰弱患者的机械通气时间、ICU住院天数,提高日常活动能力,改善肢体肌力,更利于促进疾病康复。

Objective To observe the effect of Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤)combined with acupuncture on intensive care unit(ICU)acquired weakness in patients with severe bone trauma.Methods A total of 66 severe bone trauma patients with ICU acquired weakness were divided into control group(33 cases)and observation group(33 cases)according to random number table method.The control group was given functional exercise and the observation group was treated with Huangqi Guizhi Wuwu Decoction combine with acupuncture for 2 weeks.The clinical efficacy,duration of mechanical ventilation,length of ICU stay,Barthel index(BI)score,acute physiology and chronic health evaluation scoring system(APACHE)Ⅱscore and muscle strength status(MRC)score were compared between the two groups.Results The effective rate of the observation group was 90.91%(30/33),which was higher than that of control group[69.70%(23/33)](P<0.05).The days of mechanical ventilation and ICU stay in the observation group were significantly shorter than those in the control group(P<0.05).After 14 days of treatment,the BI grade of the observation group was better than that of the control group(P<0.05).The APACHE II scores on 3 d,5 d and 7 d in the treatment group were significantly lower than those of the control group,and the MRC score of muscle strength status was significantly higher than that of the control group(P<0.05).Conclusion Huangqi Guizhi Wuwu Decoction combined with acupuncture treatment can significantly shorten the mechanical ventilation time and ICU stay days of severe bone trauma patients with ICU acquired weakness,improve the ability of daily activities and the muscle strength of the body,and promote disease recovery.