强肌健力方治疗ICU获得性肌无力的疗效观察与机制探讨  

Therapeutic Effect and Mechanism of Qiangji Jianli Recipe for Intensive Care Unit Acquired Weakness

作　　者：赵馥[1] 林新锋[1] 陈伟焘[1] 刘小斌 ZHAO Fu;LIN Xin-Feng;CHEN Wei-Tao;LIU Xiao-Bin(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;DENG Tie-Tao Research Institute,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广州中医药大学邓铁涛研究所,广东广州510405

出　　处：《广州中医药大学学报》2019年第4期481-486,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20172058);广东省科技厅-广东省中医药科学院联合专项项目(编号:2013B032500002);广州中医药大学第一附属医院"创新强院"工程科研系列青年人才培优项目(编号:2017QN05)

摘　　要：【目的】观察邓铁涛强肌健力方对重症医学科(ICU)获得性肌无力(ICU-AW)患者的临床疗效并探讨其作用机制。【方法】按数字随机表法将40例ICU-AW患者随机分为对照组和研究组,每组各20例。对照组行ICU常规治疗,研究组在对照组基础上服用强肌健力方汤剂。观察2组患者治疗前后的肌力MRC评分、中医脾虚证积分和唾液淀粉酶(sAA)活性及其酸刺激前后活性比值变化情况。【结果】(1)治疗后,2组患者的中医证候积分均较治疗前降低(P<0.05),MRC评分均较治疗前提高(P<0.05),且研究组对中医证候积分的降低作用和MRC评分的提高作用均明显优于对照组(P<0.05或P<0.01)。(2)治疗后,研究组sAA活性及其比值升高,对照组降低(P<0.01),研究组对sAA活性的改善作用优于对照组,差异均有统计学意义(P<0.01)。(3)治疗后,研究组总有效率为65.0%,高于对照组的30.0%,研究组的中医证候疗效优于对照组,差异有统计学意义(P<0.05)。(4)治疗前后三大常规、肝肾功能、凝血功能、心电图检查均未见明显异常。【结论】强肌健力方可改善ICU-AW患者临床症状,且无明显毒副作用。Objective To observe the clinical effect of Qiangji Jianli Recipe(an experienced formula prescribed by Chinese medicine master DENG Tie-Tao)on patients with intensive care unit(ICU)acquired weakness and to explore its mechanism.Methods Forty patients with ICU acquired weakness were randomly divided into control group(n=20)and study group(n=20)according to the random number.The control group received routine ICU treatment,and the study group was treated with Qiangji Jianli Recipe orally on the basis of the treatment for the control group.The Medical Research Council(MRC)scores,spleen deficiency syndrome scores,and the pre-and post-acid stimulation salivary alpha-amylase(sAA)activity and its ratio in the two groups were observed before and after treatment.Results(1)After treatment,the scores of traditional Chinese medicine(TCM)symptoms in the two groups were decreased and MRC scores were increased(P<0.05 compared with those before treatment),and the effect of the study group was stronger than that of the control group(P<0.05 or P<0.01).(2)After treatment,the pre-and post-acid stimulation sAA activity and its ratio in the study group were increased while those in the control group were decreased(P<0.01 compared with those before treatment),and the improvement of sAA activity in the study group was superior to that in the control group,the difference being significant(P<0.01).(3)After treatment,the total effective rate of the study group was 65.0%,and was higher than that in the control group(30.0%),the difference being significant(P<0.05).(4)Before and after treatment,the results of routine examination of blood,urine and stool,hepatic and renal function,coagulation function,and electrocardiography showed no abnormal changes.Conclusion Qiangji Jianli Recipe is effective on relieving the clinical symptoms of patients with ICU acquired weakness,without obviously toxic or side effects.

关 键 词：ICU获得性肌无力 强肌健力方 临床疗效 脾虚证 唾液淀粉酶活性 邓铁涛 

分 类 号：R278[医药卫生—中医学]