补中益气汤联合肠内营养治疗危重症患者胃肠功能障碍的临床观察

摘要

目的 观察补中益气汤联合肠内营养对人住ICU的危重症患者胃肠功能障碍的疗效.方法 将90例ICU住院患者按随机数字表分为两组,各45例.对照组予常规对症及肠内营养支持等治疗,治疗组在对照组治疗的基础上,加用补中益气汤鼻饲,7d为1个疗程,比较两组患者治疗后胃肠功能障碍的改善、相关实验室指标的变化及28 d生存情况.结果 治疗后治疗组总有效率77.78％,高于对照组57.78％,治疗组28 d生存率为88.89％,高于对照组的75.56％;肠鸣音次数、胃肠功能障碍评分、急性生理与慢性健康(APACHEⅡ)评分均比对照组改善更为显著(P＜0.05);治疗后治疗组血降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)等血清水平均低于对照组(均P＜ 0.05).结论 补中益气汤能够抑制危重症患者的机体炎症反应,纠正胃肠功能障碍,提高生存率,明显改善预后.%Objectivc:To observe the effect of Buzhong Yiqi Decoction combined with enteral nutrition on gastrointestinal dysfunction in critically ill patients in ICU.Methods:90 patients in ICU meeting the inclusion criteria were randomly divided into two groups.The.two groups received routine symptomatic treatment and enteral nutrition support.On the b is of the treatment of the control group,45 patients of the treatment group were given nasal feeding of Buzhong Yiqi Decoction,7 days for 1 course.The improvement of gastrointestinal dysfunction,the char,ges of related laboratory indexes and 28 da survival rate were compared between the two groups after treatment.Results:After treatment,the total effective rate of the treatment group was 77.78％,higher than that of the control group 57.78％.The survival rate of 28 lay in the treatment group was 88.89％,higher than 75.56％ in the control group.The number of bowel sounds,gastrointestinal dysfunction score,APAC HE Ⅱ score of the treatment group were improved more significantly than those of the control group,and the difference was statistically significant(P＜ 0.05).After treatment,PCT,CRP and IL-6 in the treatment group were lower than those in the control group,and the difference was statistically significant (P＜ 0.05).Conclusion:Buzhong Yiqi Decoction can inhibit the inflammatory reaction of the critically ill patients,correct the gastrointestinal dysfunction,improve the survival rate,and significantly improve the prognosis.