宽中健脾汤联合肠内营养在神经危重症患者治疗中的临床应用  

Clinical Application of Using Kuanzhong Jianpi Decoction Combined with Enteral Nutrition in the Treatment of Pa-tients with Nerve Critical Diseases

作　　者：邓开勇 刘福[1] 贺美波[1] 周超 DENG Kaiyong;LIU Fu;HE Meibo(Department of Phrmacy,the Affiliated Hospital of North Sichuan Medical College,Nanchong Sichuan 637000,China)

机构地区：[1]川北医学院附属医院药剂科,四川南充637000

出　　处：《四川中医》2020年第9期89-93,共5页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察宽中健脾汤联合肠内营养治疗神经危重症患者的疗效。方法:遴选2017年4月~2018年4月期间90例神经危重患者,选用密封信封法以1:1比例随机分为对照组和观察组,每组45例,均给予常规对症治疗,对照组给予肠内营养支持,观察组基于以上治疗给予宽中健脾汤治疗,观察两组治疗前及治疗10d的中医主要症状体征积分、临床疗效、治疗前及治疗10d后的营养指标、免疫功能指标,对比组间治疗第1、4、7、10d的氮平衡值,统计两组并发症情况。结果:治疗后,两组患者的中医主要症状体征总积分显著降低(P<0.05),观察组显著低于对照组(P<0.05);观察组的中医证候总有效率显著高于对照组(93.33%vs 73.33%,P<0.05);治疗后,两组血清总蛋白(TP)、前白蛋白(pre-ALB)、视黄醇结合蛋白(sRBP)及白蛋白(ALB)水平显著升高(P<0.05),观察组的变化幅度显著大于对照组(P<0.05);治疗后,观察组血清总淋巴细胞计数(TLC)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白M(IgA)水平显著升高(P<0.05),且均高于对照组(P<0.05);治疗第4、7、10d,两组的氮平衡值显著高于治疗第1d(P<0.05),观察组改善效果显著优于对照组(P<0.05);观察组的并发症总发生率(11.11%)显著低于对照组(17.78%)(P<0.05)。结论:宽中健脾汤联合肠内营养治疗神经危重症的疗效确切,可明显改善患者相关症状体征、营养状况和免疫系统功能,利于其快速恢复氮平衡,减少并发症发生风险。Objective:To explore the efficacy of using Kuanzhong Jianpi Decoction combined with enteral nutrition in the treatment of patients with nerve critical diseases.Methods:90 patients with nerve critical diseases from April 2017 to April 2018 were selected and randomly divided into controlled group and observation group by 1:1 ratio according to the sealed envelope method,with 45 cases in each group.The two groups were given routine symptomatic treatment,and the controlled group was given enteral nutrition support,and the observation group was given Kuanzhong Jianpi Decoction based on the above treatment.The scores of TCM main symptoms and signs before treatment and after 10 d of treatment,the clinical efficacy,and the nutritional indexes and the immune function indexes before treatment and after 10 d of treatment were observed in the two groups.The nitrogen balance value at 1st,4th,7th and 10th d of treatment was compared between the two groups,and the complications of the two groups were counted.Results:After treatment,the total scores of TCM main symptoms and signs in the two groups were significantly reduced(P<0.05),and the total score in the observation group was significantly lower than that in the controlled group(P<0.05).The total effective rate of the TCM syndromes in the observation group was significantly higher than that in the controlled group(93.33% vs 73.33%,P<0.05).After treatment,the levels of serum total protein(TP),prealbumin(pre-ALB),retinol binding protein(sRBP) and albumin(ALB) were significantly increased in the two groups(P<0.05),and the changes in the observation group were significantly greater than those in the controlled group(P<0.05).After treatment,the levels of serum total lymphocyte count(TLC),immunoglobulin M(IgM),immunoglobulin G(IgG) and immunoglobulin A(IgA) were significantly increased in the observation group(P<0.05),and were higher than those in the controlled group(P<0.05).At 4th,7th and 10th d of treatment,the nitrogen balance value in the two groups was significantly higher t

关 键 词：宽中健脾汤 肠内营养 神经危重症 

分 类 号：R605[医药卫生—外科学]