中药熏蒸联合温阳止泻汤治疗ICU患者抗生素相关腹泻的疗效观察  

作　　者：王春林 王丽萍 

机构地区：[1]浙江省衢州市中医医院,324002

出　　处：《浙江临床医学》2023年第12期1841-1843,共3页Zhejiang Clinical Medical Journal

基　　金：第五批全国中医临床优秀人才研修项目[国中医药人教函(2022)1号];衢州市科技计划指导性项目[(2020)22号]。

摘　　要：目的观察中药熏蒸联合温阳止泻汤内服治疗重症监护室(ICU)患者脾肾阳虚型抗生素相关性腹泻临床疗效。方法选取88例ICU患者脾肾阳虚型抗生素相关性腹泻患者,随机分为对照组与治疗组,每组各44例。对照组采用口服蒙脱石散、酪酸梭菌活菌片等常规治疗;治疗组使用中药熏蒸腹部神阙、气海、关元三穴配合口服自拟温阳止泻汤治疗,两组疗程均为7 d。观察两组患者腹泻持续时间,每日腹泻次数和粪便性状,以及临床疗效、治疗前后大便杆球比例变化。结果治疗组有效率为77.3%,对照组有效率为52.3%,组间比较差异有统计学意义(P<0.05)。两组治疗后大便次数、形状、肠鸣音及腹泻积分均较治疗前明显改善(P<0.05),而治疗组粪便的次数、性状及腹泻积分较对照组改善更显著,组间差异有统计学意义(P<0.05);两组粪便细菌总数及杆球比例均较治疗前明显升高(P<0.05),治疗组粪便细菌总数及杆球比例较对照组升高更为明显,组间比较有统计学意义(P<0.05)。结论运用中药熏蒸联合温阳止泻汤治疗ICU患者脾肾阳虚型抗生素相关性腹泻,能明显改善患者的临床症状及中医证候,调节肠道菌群。Objective To observe the clinical efficacy of Chinese medicine fumigation combined with Wenyang Zhi Xie decoction for antibiotic-associated diarrhea in patients with spleen-kidney yang deficiency in the intensive care unit(ICU).Methods A total of 88 patients with spleen-kidney yang deficiency and antibiotic-related diarrhea in the ICU were randomly divided into a control group and a treatment group,with 44 cases in each group.The control group was treated with conventional treatment such as oral montmorillonite powder and lactobacillus tablets,while the treatment group was treated with traditional Chinese medicine fumigating the abdominal Shenque,Qihai,and Guanyuan acupoints in combination with oral preparation of Wenyang Zhixie Decoction for 7 days.The duration of diarrhea,the number of daily diarrheas,the stool characteristics,the clinical efficacy,and the change of the stool rod/ball ratio before and after the treatment were compared between the two groups.Results The effective rate of the treatment group was 77.3%,which was higher than that of the control group 52.3%and the difference was statistically significant(P<0.05).After the treatment,the number of stools,shape,intestinal sound and diarrhea score of the two groups were significantly improved compared with those before the treatment(P<0.05),and the number of stools,characteristics and diarrhea score of the treatment group were significantly improved compared with those of the control group,and the difference between the two groups was statistically significant(P<0.05).The total number of fecal bacteria and the rod/ball ratio of the two groups were significantly increased compared with those before the treatment(P<0.05).The total number of fecal bacteria and the rod/ball ratio of the treatment group were significantly improved compared with those of the control group,and the comparison between the two groups was statistically significant(P<0.05).Conclusion The use of Chinese medicine fumigation combined with Wenyang Zhixie decoction for the treatment of

关 键 词：抗生素相关性腹泻 中药熏蒸 温阳止泻汤 脾肾阳虚 

分 类 号：R278[医药卫生—中医学]