温脾除胀汤治疗脾阳虚型胃肠功能障碍的临床效果  

The clinical effect of Wenpi Chuzhang decoction in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type

作　　者：王雷[1] 张静 金友刚 谷楠 李宝瑞 魏娜[6] 施保柱 耿艳娜 Wang Lei;Zhang Jing;Jin Yougang;Gu Nan;Li Baorui;Wei Na;Shi Baozhu;Geng Yanna(Department of Critical Care Medicine,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050013,China;Department of Urology,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050013,China;Department of General Internal Medicine,Qianxi County People′s Hospital,Hebei Province,Tangshan 064303,China;Department of General Internal Medicine,Hebei Provincial Youfu Hospital,Shijiazhuang 050062,China;Department of General Internal Medicine,Yanshan Fude Hospital,Hebei Province,Cangzhou 061399,China;Department of Respiratory Critical Care,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050013,China)

机构地区：[1]河北省中医院重症医学科,石家庄050013 [2]河北省中医院泌尿外科,石家庄050013 [3]河北省唐山市迁西县人民医院综合内科,唐山064303 [4]河北省优抚医院综合内科,石家庄050062 [5]河北省沧州市盐山阜德医院综合内科,沧州061399 [6]河北省中医院呼吸重症科,石家庄050013

出　　处：《中国医药》2025年第1期114-118,共5页China Medicine

基　　金：河北省中医药管理局科研计划项目(2021025)。

摘　　要：目的探讨温脾除胀汤治疗脾阳虚型胃肠功能障碍的临床效果。方法按随机数字表法将2021年1月至2022年9月在河北省中医院重症监护病房住院的脾阳虚型胃肠功能障碍患者50例分入观察组和对照组,各25例。对照组给予西医常规治疗,观察组在对照组的基础上予以温脾除胀汤治疗,2组均连续治疗7 d。比较2组治疗前后的临床疗效、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、中医证候积分、胃肠功能相关指标和炎症因子水平及不良反应发生情况。结果观察组总有效率明显高于对照组[96.0%(24/25)比72.0%(18/25)](P<0.05)。治疗后2组患者APACHEⅡ评分、中医证候积分均低于治疗前,且观察组均低于对照组(均P<0.05)。治疗后2组胃肠功能障碍评分、腹内压、腹围、平均胃潴留量均低于/小于治疗前,且观察组上述指标均低于/小于对照组(均P<0.05)。治疗后2组患者白细胞计数、肿瘤坏死因子α、降钙素原水平均低于治疗前,且观察组各炎症因子水平均低于对照组(均P<0.05)。治疗期间,2组患者均未出现不良反应,同时患者血常规、尿常规、便常规指标均保持正常。结论温脾除胀汤治疗脾阳虚型胃肠功能障碍患者效果确切,能改善患者胃肠功能,抑制炎症因子。Objective To investigate the clinical effect of Wenpi Chuzhang decoction in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type.Methods According to the random number table method,50 patients with gastrointestinal dysfunction of spleen Yang deficiency type who were hospitalized in the Department of Critical Care Medicine,Hebei Provincial Hospital of Traditional Chinese Medicine from January 2021 to September 2022 were divided into observation group and control group,with 25 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Wenpi Chuzhang decoction on the basis of the control group.Both groups were treated for 7 d.The clinical efficacy,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,traditional Chinese medicine(TCM)syndrome score,gastrointestinal function related indicators,inflammatory factor levels and adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group[96.0%(24/25)vs 72.0%(18/25)](P<0.05).After treatment,the APACHEⅡscore and TCM syndrome score of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group(all P<0.05).After treatment,the gastrointestinal dysfunction score,intra-abdominal pressure,abdominal circumference,and average gastric retention in the two groups were lower/less than those before treatment,and the above indexes in the observation group were lower/less than those in the control group(all P<0.05).After treatment,the white blood cell count,tumor necrosis factor-α,and procalcitonin levels of the two groups were lower than those before treatment,and the levels of inflammatory factors in the observation group were lower than those in the control group(all P<0.05).During the treatment period,there were no adverse reactions in the two groups,and the routine indexes

关 键 词：胃肠功能障碍 温脾除胀汤 脾阳虚型 急性生理学与慢性健康状况评分系统Ⅱ评分 

分 类 号：R573[医药卫生—消化系统]