参苓白术散联合肠内营养治疗老年多器官功能不全综合征合并营养不良的临床疗效评价  

Evaluation of clinical effect of Shenling Baizhu Powder combined with enteral nutrition in treating MODSE with malnutrition

作　　者：王慧 孔令信[3] 胡晓飞 孙志广[2] 李正光[1] WANG Hui;KONG Ling-xin;HU Xiao-fei;SUN Zhi-guang;LI Zheng-guang(Qingdao Hospital of Traditional Chinese Medicine(Municipal Hiser Hospital),Qingdao 266033,China;Nanjing University of Chinese Medicine,Nanjing 210023,China;The Affliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛市中医医院(市海慈医院),青岛266033 [2]南京中医药大学,南京210023 [3]青岛大学附属医院,青岛266003

出　　处：《中华中医药杂志》2022年第11期6847-6850,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：山东省中医药科技发展计划项目(No.2015-353);青岛市中医药科研计划项目(No.2020-zyy002);青岛市医疗卫生优秀学科带头人培养项目(No.青卫科教字[2019]9号)。

摘　　要：目的:观察参苓白术散联合肠内营养治疗老年多器官功能不全综合征(MODSE)合并营养不良患者的临床疗效。方法:将60例MODSE合并营养不良的患者随机分为治疗组30例和对照组30例。治疗组予以西医常规治疗、肠内营养支持治疗加参苓白术散,对照组予以西医常规治疗、肠内营养支持治疗加等量温开水,28 d为1个疗程。比较两组患者治疗前后临床疗效、中医证候积分、急性生理与慢性健康评分(APACHEⅡ)评分、主观整体营养状况评估量表(PG-SGA)评分,并抽取空腹静脉血检测血清前白蛋白(PA)、白蛋白(ALB)、淋巴细胞计数(LY)等指标进行比较。结果:治疗后治疗组总有效率高于对照组(P<0.05),死亡率低于对照组(P<0.05)。两组治疗后中医证候积分、APACHEⅡ评分、PG-SGA评分均较治疗前降低(P<0.05,P<0.01),实验室指标(PA、ALB、LY,除对照组PA外)升高(P<0.05),且治疗组临床总有效率、死亡率、中医证候积分、APACHEⅡ评分、PG-SGA评分以及PA、ALB、LY指标改善程度优于对照组(P<0.05)。结论:参苓白术散联合肠内营养治疗MODSE合并营养不良患者具有良好的临床效果,值得临床推广应用。Objective:To evaluate the clinical effect of Shenling Baizhu Powder combined with enteral nutrition on patients with MODSE and malnutrition.Methods:A total of 60 patients with MODSE and malnutrition were randomly divided into treatment group(30 cases)and control group(30 cases).The treatment group was treated with basic western medicine,enteral nutrition and Shenling Baizhu Powder.The control group was treated with basic western medicine,enteral nutrition and equal amount of warm boiled water.The treatment course was 28 days.Total effective rate,TCM symptom score,APACHE I score,PG-SGA score,prealbumin(PA),albumin(ALB)and lymphocyte(LY)were recorded before and after treatment.Results:After treatment,the total effective rate of the treatment group was higher than that of the control group(P<0.05),and the mortality rate was lower than that of the control group(P<0.05).After treatment,TCM symptom score,APACHE I score and PG-SGA score in the two groups were lower than that before the treatment(P<0.05,P<0.01),PA,ALB and LY were higher than that before the treatment(P<0.05),and the improvement degree of total effective rate,mortality rate,TCM symptom score,APACHE II score,PG-SGA score,PA,ALB and LY in the treatment group was significantly better than those in the control group(P<0.05).Conclusion:Shenling Baizhu Powder combined with enteral nutrition is effective for the treatment of MODSE with malnutrition,which is worthy of clinical application and promotion.

关 键 词：参苓白术散 肠内营养 老年多器官功能不全综合征 脾胃虚弱证 营养不良 疗效评价 

分 类 号：R459.7[医药卫生—急诊医学]