中医治疗对脑卒中患者肠内营养胃肠道并发症及胃肠激素的影响  

The Influence of Treatment from the Liver on Enteral Nutrition Gastrointestinal Complications and Gastrointestinal Hormones of Patients with Cerebral Apoplexy

作　　者：张思为 周志 山林林[3] 王玉龙[3] ZHANG Si-wei;ZHOU Zhi;SHAN Lin-lin;WANG Yu-long(1.Shenzhen People＇s Hospital;Shenzhen Institute of Drug Inspection and Research;Shenzhen No.2 People＇s Hospital; Shenzhen, Guangdong, China, 51803)

机构地区：[1]深圳市人民医院,广东深圳518020 [2]深圳市药品检验研究院,广东深圳518000 [3]深圳市第二人民医院,广东深圳518035

出　　处：《河南中医》2018年第2期244-248,共5页Henan Traditional Chinese Medicine

基　　金：2015年广东省中医药强省建设专项资金第二批名中医师承项目(编号:粤中医办函[2015]93号);深圳市科技计划项目(编号:JCYJ20140416122811947)

摘　　要：目的:观察中医治疗对脑卒中后肠内营养患者胃肠道并发症及胃肠激素的影响。方法:选取2014年6月至2016年10月在深圳市人民医院及深圳市第二人民医院住院的脑卒中患者160例,按照随机数字表法分为对照组、益气健脾组、祛湿组和从肝论治组,每组40例。各组患者均接受常规药物治疗,对照组患者于入院48 h内留置鼻胃管,实施肠内营养支持,益气健脾组在对照组治疗的基础上给予四君子汤治疗,祛湿组在对照组治疗的基础上给予藿香正气散治疗,从肝论治组在对照组治疗的基础上给予肝胃百合汤治疗,连续治疗28 d。比较各组胃肠道并发症发生率,检测患者胃肠激素(胃动素、胃泌素)的浓度。结果:从肝论治组胃潴留发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组反流发生率低于对照组和益气健脾组(P<0.05),也低于祛湿组,但差异无统计学意义(P>0.05)。从肝论治组呕吐发生率低于对照组(P<0.05),也低于益气健脾组和祛湿组,但差异无统计学意义(P>0.05)。从肝论治组腹胀发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组便秘发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组腹泻发生率低于对照组(P<0.05),也低于益气健脾组和祛湿组,但差异无统计学意义(P>0.05)。从肝论治组胃肠道出血发生率低于对照组、益气健脾组和祛湿组(P<0.05)。从肝论治组胃动素、胃泌素水平优于对照组及益气健脾组、祛湿组(P<0.05)。结论:脑卒中后肠内营养患者给予肝胃百合汤治疗有助于减少胃肠道并发症的发生率,其机制可能与调节胃肠激素的浓度有关。Objective： To observe the influence of Liver-Stomach Lily Bulb Decoction on enteral nutrition gastrointestinal complications and gastrointestinal hormones of patients with cerebral apoplexy. Methods： One hundred patients who received enteral nutrition treatment within 48 hours after cerebral apoplexy were chosen as the research subjects,and randomly divided into the control group,the group of supplementing qi to invigorate the spleen（the SQIS group）,the group of removing dampness,the group of treatment from the liver,with 40 cases in each group. The control group was given conventional treatment and enteral nutrition,and the rest groups were given Four Gentlemen＇s Decoction,Huoxiang Zhengqi Powder（HXZQP）,Liver-Stomach Lily Bulb Decoction respectively,for continuous treatment of 28 days. The incidence of gastrointestinal complications in each group was compared and the concentration of gastrointestinal hormones（motilin and gastrin） in the patients was measured. Results： The gastric retention rate of the group of treatment from the liver was lower than those of the control group,the SQIS group,and the group of removing dampness（P 0. 05）. The incidence rate of reflux of the group of treatment from the liver was lower than those of the control group,the SQIS group,and the group of removing dampness（P 0. 05）,but the difference was not statistically significant（P 0. 05）. The incidence rate of vomiting of the group of treatment from the liver was lower than those of the control group,the SQIS group,and the group of removing dampness（P 0. 05）,but the difference was not statistically significant（P 0. 05）. The incidence of abdominal distension of the group of treatment from the liver was lower than those of the control group,the SQIS group,and the group of removing dampness（P 0. 05）. The incidence of constipation of the group of treatment from the liver was lower than those of the control group,the SQIS group,and the group of removing dampness（P 0. 05）. The incidence of diarr

关 键 词：肝胃百合汤 脑卒中 肠内营养 胃肠道并发症 胃肠激素 

分 类 号：R255.2[医药卫生—中医内科学]