大承气汤联合早期肠内营养治疗急性胃肠损伤患者的疗效  

Dachengqi Decoction combined with early enteral nutrition in the treatment of patients with acute gastrointestinal injury

作　　者：蒋永泼 王雯丹[1] 陈南瑾 张巧敏 王雅飞 张梦芹 张胜[1] 崔可[1] 林荣海[1] JIANG Yongpo;WANG Wendan;CHEN Nanjin;ZHANG Qiaomin;WANG Yafei;ZHANG Mengqin;ZHANG Sheng;CUI Ke;LIN Ronghai(Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江省台州医院重症医学科,浙江台州317000

出　　处：《实用医学杂志》2020年第16期2305-2308,共4页The Journal of Practical Medicine

基　　金：浙江省中医药管理局基金资助项目(编号:2014ZA123)。

摘　　要：目的探讨大承气汤联合早期肠内营养对急性胃肠损伤患者预后的影响。方法2016年6月至2017年5月,纳入收住浙江省台州医院重症医学科,伴有急性胃肠损伤(Acute Gastrointestinal Injury,AGI)的重症患者,采用随机数字表进行随机分为2组:试验组(n=52):大承气汤联合早期肠内营养;对照组(n=46):早期肠内营养。比较两组患者的AGI评分、前白蛋白、住ICU及总住院时间,28 d院内死亡率等。结果两组患者在年龄、性别、体质量指数、APACHEII、SOFA、NRS2002、白蛋白、原发疾病、肠道耐受情况等比较,差异无统计学意义(P>0.05);试验组患者第7天AGI、前白蛋白水平均优于对照组,差异有统计学意义(P<0.05);试验组住ICU时间比较对照组,差异无统计学意义(P>0.05);试验组住院时间比较对照组短,差异有统计学意义(P<0.05);试验组患者28天院内死亡率15.2%;对照组患者死亡率9.6%,两组死亡率差异无统计学意义(P>0.05)。结论大承气汤联合早期肠内营养可以改善急性胃肠损伤患者胃肠功能、营养状态及缩短住院时间,但未发现可以改善急性胃肠损伤患者预后。Objective To investigate the effect of Dachengqi Decoction combined with early enteral nutrition on the prognosis of patients with acute gastrointestinal injury.Methods From June 2016 to May 2017,the critically ill patients with acute gastrointestinal injury(AGI)admitted to the Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province were randomly divided into 2 groups.Experimental group(n=52):Dachengqi decoction combined with early enteral nutrition;control group(n=46):early enteral nutrition.The AGI scores and pre-albumin,length of ICU stay and hospital stay,and 28-day in-hospital mortality were compared between the two groups.Results There were no significant differences in the baseline characteristics of age,gender,body mass index,APACHE II,SOFA,NRS2002,and albumin between the two groups(P>0.05).The AGI and prealbumin levels were superior on the 7 th day in the experimental group.In the control group,the difference was statistically significant(P<0.05);the experimental group lived in the IC.U compared with the control group,the difference was not statistically significant(P>0.05);The group hospitalization time was shorter in the control group,the difference was statistically significant(P<0.05);the mortality rate in the experimental group was 15.2%;the mortality in the control group was 9.6%.There was no significant difference in hospital mortality between the two groups(P>0.05).Conclusion Dachengqi Decoction combined with early enteral nutrition can improve gastrointestinal function,nutritional status and hospitalization time in patients with acute gastrointestinal injury,but it has not been found to improve the prognosis of patients with acute gastrointestinal injury.

关 键 词：大承气汤 急性胃肠损伤 早期肠内营养 预后 

分 类 号：R289[医药卫生—方剂学]