加味四君子汤对重症脑卒中患者胃排空障碍的临床研究  

Clinical study of modified Sijunzi decoction on delayed gastric emptying in patients with severe stroke

作　　者：许冠华[1] 沈建军[1] 俞林峰[1] 莫路姣 黄旭华 金王燕[1] 王云超[1] 沈晓圆[1] XU Guanhua;SHEN Jianjun;YU Linfeng(Department of Critical Care Medicine,Hangzhou Xiaoshan District First People's Hospital,Zhejiang,Hangzhou 311200,China)

机构地区：[1]杭州市萧山区第一人民医院重症医学科,浙江杭州311200

出　　处：《全科医学临床与教育》2022年第8期685-688,共4页Clinical Education of General Practice

基　　金：萧山区科技局社会发展重大科技计划政策引导项目(2019303);杭州市医药卫生科技项目(OO20190952)。

摘　　要：目的 探讨加味四君子汤对重症脑卒中患者胃排空障碍的临床疗效。方法 选取重症脑卒中患者200例,按照随机数字法分为观察组和对照组,对照组予胃复安联合莫沙必利治疗,观察组在对照组基础上联合加味四君子汤治疗。比较两组患者治疗前和治疗5 d后的肠鸣音、大便次数、胃纳潴留量、炎症因子表达、肺部感染例数、肠内营养量及治疗7 d后免疫相关指标的变化。结果 治疗5 d后,观察组患者的肠鸣音、大便次数多于对照组,胃纳潴留量、肺部感染例数少于对照组,差异均有统计学意义(t分别=17.25、7.44、-18.09,χ^(2)=6.08,P均<0.05),白细胞计数(WBC)、C反应蛋白(CRP)表达水平低于对照组,肠内营养量、前白蛋白、白蛋白高于对照组,差异均有统计学意义(t分别=21.43、17.33、9.91、2.88、9.51,P均<0.05)。治疗7 d后,观察组患者的CD^(3+)、CD^(4+)、CD^(4+)/CD^(8+)高于对照组,差异均有统计学意义(t分别=13.95、6.51、5.93,P均<0.05)。结论 加味四君子汤能明显改善重症脑卒中患者胃排空障碍的胃肠道运动功能,降低炎症因子表达及肺部感染人数,提高营养状态及免疫功能。Objective To explore the clinical effect of modified Sijunzi decoction on delayed gastric emptying in patients with severe stroke injury. Methods A total of 200 patients with severe stroke were selected and divided into observation group and control group according to random number method.The control group was given metoclopramide combined with mosapride.The observation group was additionally treated with modified Sijunzi decoction.The changes of bowel sounds,stool frequency,gastric retention,inflammatory factors expression,cases of lung infection,the amount of enteral nutrition were compared between the two groups before treatment and on the 5th day after treatment as well as the immune-related parameters on the 7th day after treatment.Results After 5 days of treatment,the intestinal sounds and stool frequency of patients in the observation group were more than those in the control group,the amount of gastric absorption retention,the cases of pulmonary infections were less than those in the control group(t=17.25,7.44,-18.09,χ^(2)=6.08,P<0.05),the expressions of WBC and CRP were lower than those in the control group,the amount of enteral nutrition,prealbumin,albumin were higher than those of the control group,and the differences were statistically significant(t=21.43,17.33,9.91,2.88,9.51,P<0.05).After 7 days of treatment,CD^(3+),CD^(4+),CD^(4+)/CD^(8+)were higher than those of the control group,and the differences were statistically significant(t=13.95,6.51,5.93,P<0.05). Conclusion Modified Sijunzi decoction can significantly improve gastrointestinal motor function of patients with severe stroke caused by delayed gastric emptying,reduce the expression of inflammatory factors and the number of lung infections,improve nutritional status and immune function,which is worthy of clinical application.

关 键 词：加味四君子汤 胃排空障碍 重症脑卒中 炎症因子 肺部感染 

分 类 号：R743.3[医药卫生—神经病学与精神病学]