补中益气汤对重症肺炎(肺脾气虚证)机械通气患者膈肌功能的影响  

The effect of Buzhong Yiqi decoction on diaphragm function in mechanical ventilation patients with severe pneumonia(lung and spleen Qi deficiency syndrome)

作　　者：陈波 林恩珍 张玲梅[1] 王施玮[1] 陈腾飞[1] 肖斌[1] 林兰[1] 郑文贺[1] CHEN Bo;LIN Enzhen;ZHANG Lingmei;WANG Shiwei;CHEN Tengfei;XIAO Bin;LIN Lan;ZHENG Wenhe

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350001 [2]福建中医药大学附属人民医院,福建福州350004

出　　处：《中医临床研究》2024年第3期19-23,共5页Clinical Journal Of Chinese Medicine

基　　金：福建省自然科学基金项目(2021J01869);福建省教育厅中青年教师教育科研项目(JAT190275)。

摘　　要：目的:研究补中益气汤对重症肺炎(肺脾气虚证)机械通气患者膈肌功能的影响。方法:将66例患者运用随机数字表法分为补中益气汤组及对照组各33例,对照组予西医常规治疗,补中益气汤组在常规治疗基础上加予补中益气汤加减治疗,疗程均为7 d,治疗第1、3、5、7天运用床旁超声测定患者膈肌移动度及膈肌增厚率以评价膈肌功能,并计算脱机成功率。结果:两组患者治疗第1、3、5、7天膈肌移动度差异无统计学意义。补中益气汤组治疗第5、7天吸气末膈肌厚度高于对照组(P <0.05)。两组患者治疗第1、3、5天膈肌增厚率差异无统计学意义。治疗7 d后补中益气汤组膈肌增厚率[(40.87±16.48)%]高于对照组[(32.49±13.34)%](P <0.05)。两组治疗前急性生理功能和慢性健康状况评分系统Ⅱ评分别为(19.00±6.69)分、(17.73±6.02)分,治疗后分别为(11.82±4.51)分、(12.45±2.39)分,差异均无统计学意义(P> 0.05)。补中益气汤组脱机成功率为63.6%,对照组为51.5%,补中益气汤组高于对照组,差异无统计学意义。结论:补中益气汤有利于增加重症肺炎(肺脾气虚证)机械通气患者吸气末膈肌厚度及膈肌增厚率,改善膈肌功能。Objective:To study the effect of Buzhong Yiqi decoction(补中益气汤) on diaphragm function in mechanical ventilation patients with severe pneumonia of lung and spleen Qi(气) deficiency syndrome.Methods:A total of 66 patients were randomly divided into the Buzhong Yiqi decoction group and the control group,with 33 cases in each group.The control group was given conventional Western medicine treatment,and the Buzhong Yiqi decoction group was given Buzhong Yiqi decoction on the basis of conventional treatment.The course of treatment was 7 days.On the 1st,3rd,5th,and 7th days of treatment,bedside ultrasound was used to measure the degree of diaphragm movement and the thickening rate of diaphragm to evaluate diaphragm function.The offline success rate was calculated.Results:There was no significant difference in diaphragm movement between the two groups on the 1st,3rd,5th and 7th day of treatment.The diaphragmatic muscle thickness in the Buzhong Yiqi decoction group was higher than that in the control group at the end of inspiratory breath on the 5th and 7th days after treatment(P<0.05).There was no significant difference in the thickening rate of diaphragm between two groups on the 1st,3rd and 5th day of treatment.After 7 days of treatment,the thickening rate of diaphragm in Buzhong Yiqi decoction group [(40.87±16.48) %] was higher than that in the control group [(32.49±13.34) %](P<0.05).The APACHE II scores in the two groups were(19.00±6.69) and(17.73±6.02),respectively before treatment,and(11.82±4.51) and(12.45±2.39) after treatment,respectively,and the difference was not statistically significant(P>0.05).The offline success rate was 63.6% in the Buzhong Yiqi decoction group and 51.5% in the control group.The offline success rate in the Buzhong Yiqi decoction group was higher than the control group,and the difference was not statistically significant.Conclusion:Buzhong Yiqi decoction is beneficial to increase the diaphragm thickness and the diaphragm thickening rate at the end of inspiratory breath in pa

关 键 词：补中益气汤 重症肺炎 机械通气 重症超声 膈肌功能 

分 类 号：R256.1[医药卫生—中医内科学]