针灸联合补中益气汤治疗肠内营养不耐受并发ICU获得性衰弱临床观察  

Clinical Observation of Acupuncture Combined with Buzhong Yiqi Decoction(补中益气汤)in Treatment of Patients with Enteral Nutrition Intolerance Complicated with ICU-acquired Weakness

作　　者：蒋文[1] 罗真春 JIANG Wen;LUO Zhenchun(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中华中医药学刊》2023年第6期195-200,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：重庆市科研院所绩效激励引导专项(cstc2017jxjl130003)。

摘　　要：目的探讨针灸联合补中益气汤治疗肠内营养不耐受并发重症监护病房获得性衰弱(Intensive Care Unit ae⁃quired weakness,ICU-AW)患者的效果。方法选取2018年5月—2020年6月重庆市中医院急诊ICU收治的108例ICU-AW患者为研究对象,以随机数字表法分研究组和对照组,各54例。对照组给予常规治疗联合针灸,研究组在对照组的基础上另给予补中益气汤,连续治疗2周后观察效果。记录两组中医症状评分、临床疗效,对比两组肌力、胃肠功能、肠道菌群及营养状况,记录两组治疗期间不良事件发生情况。结果两组治疗后的主症、次症中医证候评分均低于治疗前(P<0.05),研究组治疗后的主症、次症中医证候评分均低于对照组(P<0.05)。研究组总有效率为高于对照组(P<0.05)。两组治疗后医学研究委员会(Medical Research Council,MRC)肌力评分均高于治疗前(P<0.05),研究组治疗后MRC肌力评分高于对照组(P<0.05)。两组治疗后的胃泌素(Gastrin,GAS)均低于治疗前,两组治疗后的生长抑素(somatostatin,SST)、胃动素(motilin,MTL)均高于治疗前(P<0.05);研究组治疗后的GAS低于对照组,研究组治疗后的SST、MTL均高于对照组(P<0.05)。两组治疗后的肠杆菌均低于治疗前,两组治疗后的乳酸杆菌、双歧杆菌均高于治疗前(P<0.05);研究组治疗后的肠杆菌低于对照组,研究组治疗后的乳酸杆菌、双歧杆菌均高于对照组(P<0.05)。两组治疗后的白蛋白(albumin,ALB)、前白蛋白(prealbumin,PAB)、转铁蛋白(transferrin,TRF)均高于治疗前(P<0.05),研究组治疗后的ALB、PAB、TRF均高于对照组(P<0.05)。两组总不良反应发生率对比差异无统计学意义(P>0.05)。结论针灸联合补中益气汤治疗肠内营养不耐受并发ICU-AW患者可增强治疗疗效,改善患者肌力、胃肠功能、肠道菌群及营养状况,且安全性良好。Objective To investigate the effect of acupuncture combined with Buzhong Yiqi Decoction(补中益气汤)in the treatment of enteral nutrition intolerance complicated with intensive care unit-acquired weakness(ICU-AW).Methods A total of 108 ICU-AW patients admitted to the emergency ICU of Chongqing Traditional Chinese Medicine Hospital from May 2018 to June 2020 were selected as the research objects and divided into the study group and the control group by random number table method,with 54 cases in each.The control group was given routine treatment combined with acupuncture,and the study group was given Buzhong Yiqi Decoction on the basis of the control group,and the effect was observed after 2 weeks of continuous treat⁃ment.The TCM symptom scores and clinical efficacy of the two groups were counted.Muscle strength,gastrointestinal function,intestinal flora and nutritional status were compared between the two groups.The occurrence of adverse events during treatment in both groups was recorded.Results The TCM syndrome scores of the main symptoms and secondary symptoms in the two groups af⁃ter treatment were lower than those before treatment(P<0.05).The total effective rate of the study group was higher than that of the control group(P<0.05).The medical research committee(MRC)muscle strength scores of the two groups after treatment were lower than those before treatment(P<0.05),and the MRC muscle strength scores of the study group after treatment were lower than those of the control group(P<0.05).The gastrin levels in the two groups after treatment were lower than those before treatment,and the levels of somatostatin and motilin in the two groups after treatment were higher than those before treatment(P<0.05).The gastrin in the study group after treatment was lower than that in the control group,and the levels of somatostatin and motilin in the study group after treatment were higher than those in the control group(P<0.05).The Enterobacteriaceae after treatment in the two groups were lower than those before tre

关 键 词：肠内营养不耐受 重症监护病房获得性衰弱 针灸 补中益气汤 效果 

分 类 号：R245.31[医药卫生—针灸推拿学]