四逆汤联合四神汤加味辅助治疗ICU抗生素相关性腹泻临床研究  

Clinical Study on Modified Sini Tang Combined with Sishen Tang in Adjuvant Treatment for Antibiotic-associated Diarrhea in ICU

作　　者：邵兴[1] 朱秀琪 朱莉[1] 王黎明[1] 陈琨[1] SHAO Xing;ZHU Xiuqi;ZHU Li;WANG Liming;CHEN Kun

机构地区：[1]金华市中心医院重症医学科,浙江金华321000

出　　处：《新中医》2020年第10期50-52,共3页New Chinese Medicine

摘　　要：目的:观察四逆汤联合四神汤加味辅助治疗重症监护室(ICU)脾肾阳虚证抗生素相关性腹泻临床疗效。方法:将80例脾肾阳虚证抗生素相关性腹泻患者随机分为2组各40例。对照组均采用胃管注入蒙脱石散剂、布拉氏酵母菌散等常规治疗;观察组在对照组治疗方案的基础上加服四逆汤联合四神汤加味,2组均连续治疗10 d。比较2组肠内营养热量达标情况、治疗前后大便杆/球比值变化、不同时间段腹泻程度积分及治疗总有效率。结果:观察组总有效率为87.5%,高于对照组的65.0%,差异有统计学意义(P<0.05)。治疗后,观察组肠内营养摄入量达标率明显高于对照组,差异有统计学意义(P<0.05)。治疗后,2组大便杆/球比例失调变化比较,差异有统计学意义(P<0.05)。观察组治疗第1天腹泻程度积分数值稍低于对照组,但差异无统计学意义(P>0.05),观察组治疗第4天、第7天、第10天的腹泻程度积分明显低于对照组,差异均有统计学意义(P<0.05)。结论:ICU脾肾阳虚证抗生素相关性腹泻患者采用四逆汤联合四神汤加味辅助治疗,可明显改善临床症状,有助于提高临床疗效。Objective:To observe the clinical effect of modified Sini tang combined with Sishen tang in adjuvant treatment for antibiotic-associated diarrhea with spleen-kidney yang deficiency syndrome in intensive care unit(ICU).Methods:A total of 80 cases of patients with antibiotic-associated diarrhea with spleen-kidney yang deficiency syndrome were randomly divided into two groups,40 cases in each group.The control group was injected with smectite powder and saccharomyces boulardii powder by gastric tube,and the observation group was additionally treated with modified Sini tang combined with Sishen tang based on the treatment of the control group.Both groups were treated for ten days.The standard-reaching status of enteral nutrition and heat,the changes of ratio to bacillus and coccus in the stool before and after treatment,the scores of degree of diarrhea at different time segments and the total effective rate in the two groups were compared.Results:The total effective rate was 87.5%in the observation group,higher than that of 65.0%in the control group,the difference being significant(P<0.05).After treatment,the standard-reaching rate of enteral nutrition intake in the observation group was significantly higher than that in the control group,the difference being significant(P<0.05).After treatment,the comparison of imbalance of ratio to bacillus and coccus between the two groups showed significance in differences(P<0.05).On the first day of treatment,the score of diarrhea in the observation group was lower than that in the control group,but there being no significance in the difference(P>0.05);on the fourth,seventh and tenth day of treatment,the scores of diarrhea in the observation group were significantly lower than those in the control group,differences being significant(P<0.05).Conclusion:The therapy of modified Sini tang combined with Sishen tang in adjuvant treatment for antibiotic-associated diarrhea with spleen-kidney yang deficiency syndrome in ICU can significantly improve clinical symptoms and clinical effect

关 键 词：抗生素相关性腹泻 脾肾阳虚证 重症监护室 四逆汤 四神汤 

分 类 号：R442.2[医药卫生—诊断学]