参苓白术散对老年多器官功能不全合并营养不良患者营养状况及免疫功能的影响  

Effects of shenling baizhu powder on nutritional status and immune function in elderly patients with multiple organ dysfunction complicated with malnutrition

作　　者：张佩芝 王慧 李平海 李正光[2] 王惠莹 ZHANG Peizhi;WANG Hui;LI Pinghai;LI Zhengguang;WANG Huiying(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Ji'nan 250355,Shandong,China;Department of Cardiovascular Medicine(the 3 rd Division),Qingdao Hospital of Traditional Chinese Medicine&Qingdao Hiser Hospital,Qingdao 266033,Shandong,China;Department of Outpatient,Unit 91286 of PLA,Qingdao 266021,Shandong,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250355 [2]青岛市中医医院&青岛市海慈医院心血管三科·全科医学科,山东青岛266033 [3]解放军91286部队门诊部,山东青岛266021

出　　处：《贵州医科大学学报》2022年第11期1339-1343,1348,共6页Journal of Guizhou Medical University

基　　金：山东省中医药科技项目(Q-2022006);青岛市中医药科研计划项目(2020-zyy002)。

摘　　要：目的探讨参苓白术散对老年多器官功能不全(MODSE)合并营养不良患者营养状况及免疫功能的影响。方法80例MODSE合并营养不良患者随机分为对照组和实验组,对照组采用西医对症治疗,实验组在对照组治疗的基础上给予参苓白术散中药煎剂口服或鼻饲,两组均治疗4周;比较两组患者治疗前后的中医证候积分,采集空腹静脉血检测血清白蛋白(ALB)、血清前白蛋白(PA)、血红蛋白(Hb)、血清总蛋白(TP)等营养学指标,比较T淋巴细胞百分比(CD3^(+))、辅助/诱导T淋巴细胞百分比(CD4^(+))、辅助/抑制T淋巴细胞比值(CD4^(+)/CD8^(+))、自然杀伤细胞百分比(NK),观察不良反应发生情况。结果治疗后,2组患者中医证候积分均较治疗前降低,且实验组低于对照组(P<0.05);治疗后,实验组患者血清ALB、PA、Hb、TP水平以及CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK水平均较治疗前提高(P<0.05),且实验组高于对照组(P<0.05);2组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论在西医治疗的基础上给予参苓白术散治疗能显著改善MODSE合并营养不良患者的中医证候积分、营养状况及免疫功能。Objective To investigate the effects of Shenling Baizhu powder on nutritional status and immune function of multiple organ dysfunction syndrome in the elderly(MODSE)complicated with malnutrition.Methods Eighty patients with MODSE combined with malnutrition were randomly divided into control and experimental groups.Control group received conventional Western medicine symptomatic treatment,and the experimental group was given Western medicine symptomatic treatment^(+)Shenling Baizhu powder by oral or nasal feeding.The treatment lasted for 4 weeks.Traditional Chinese medicine syndrome scores were compared between two groups before and after the treatment.Fasting venous blood was collected to detect serum albumin(ALB),serum prealbumin(PA),hemoglobin(Hb),and serum total protein(TP),etc.The percentage of T lymphocytes(CD3^(+)),the percentage of helper/induced T lymphocytes(CD4^(+)),the ratio of CD4^(+)/CD8^(+)T cells,and the percentage of natural killer(NK)cells were compared between two groups.The adverse reactions of the two groups were observed.Results After treatment,traditional Chinese medicine syndrome score of both groups was lower than that before treatment,and it was lower in experimental group than that in control group(P<0.05).After treatment,the levels of serum ALB,PA,Hb,TP,and CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells in experimental group were increased relative to those before treatment(P<0.05),and they were higher in experimental group than in control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion On the basis of western medicine treatment,Shenling Baizhu powder can significantly improve the traditional Chinese medicine syndrome score,nutritional status,and immune function of MODSE patients with malnutrition.

关 键 词：参苓白术散 老年多器官功能不全综合征 营养不良 营养状况 淋巴细胞亚群 免疫功能 中医证候积分 

分 类 号：R259[医药卫生—中西医结合] R592[医药卫生—中医内科学]