黄连汤“昼三夜二”分时给药改善脓毒症相关获得性衰弱随机对照研究  

aking Huanglian Decoction Thrice by day and Twice by Night on Sepsis-Related Acquired Weakness:A Randomized Controlled Trial

作　　者：方蕊 李探 张潇月 费立博 邵龙刚 蒋华 刘克琴 FANG Rui;LI Tan;ZHANG Xiao-yue;FEI Li-bo;SHAO Long-gang;JIANG Hua;LIU Ke-qin(Second Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing,210023;Department of Emergency Medicine,The Second Affiliated Hospital of Nanjing University of Chinese Medicine(The Second Chinese Medicine Hospital of Jiangsu Province),Nanjing,210017;Department of Critical Care Medicine,The First Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Province Hospital of Traditional Chinese Medicine),Nanjing,210029)

机构地区：[1]南京中医药大学第二临床医学院,南京210023 [2]南京中医药大学第二附属医院(江苏省第二中医院)急诊科,南京210017 [3]南京中医药大学第一附属医院(江苏省中医院)重症医学科,南京210029

出　　处：《中国中西医结合杂志》2024年第12期1443-1449,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：江苏省中医药管理局重点项目(No.ZD202204);江苏省中医药科技发展计划项目(No.MS2022042,No.MS2022036);南京市中西医结合疫病研究中心科研基金资助项目(No.NCMIC-2022-08)。

摘　　要：目的 观察黄连汤“昼三夜二”分时给药对脓毒症相关获得性衰弱的临床疗效。方法 纳入南京中医药大学第二附属医院急危重症医学科2023年1月—2024年5月收治的60例脓毒症相关获得性衰弱的患者,随机分为对照组、黄连汤组和黄连汤对照组,每组20例,均给予常规营养支持,黄连汤组采用“昼三夜二”法分次服用黄连汤,黄连汤对照组采用常规早晚两次服用黄连汤,治疗14天。治疗前后测量肱二头肌、股直肌厚度、膈肌移动度、膈肌增厚率;检测血清血红蛋白、白蛋白、前白蛋白水平。计算各组患者28、90天生存率。结果 黄连汤组2例脱落,黄连汤对照组1例脱落。与本组治疗前比较,对照组及黄连汤对照组治疗7天股直肌肌肉厚度、膈肌移动度增加,7、14天肱二头肌、股直肌肌肉厚度、膈肌移动度、膈肌增厚率增加,治疗14天血清白蛋白、前白蛋白升高(P<0.05);黄连汤组治疗7、14天肱二头肌、股直肌肌肉厚度、膈肌移动度、膈肌增厚率增加,治疗14天血清白蛋白、前白蛋白升高(P<0.05)。与对照组同期比较,黄连汤对照组治疗14天股直肌肌肉厚度、血清血红蛋白、前白蛋白水平升高,治疗7、14天膈肌移动度增加(P<0.05);黄连汤组治疗7、14天肱二头肌、股直肌肌肉厚度、膈肌增厚率、膈肌移动度增加,治疗14天血清血红蛋白、前白蛋白、白蛋白水平升高(P<0.05)。与黄连汤对照组同期比较,黄连汤组治疗7天股直肌肌肉厚度、膈肌移动度增加,治疗7、14天肱二头肌、股直肌肌肉厚度、膈肌移动度增加,治疗14天血清血红蛋白、前白蛋白、白蛋白水平升高(P<0.05)。与对照组比较,黄连汤对照组的28、90天生存率差异无统计学意义(P>0.05),黄连汤组28、90天生存率升高(P<0.05)。与黄连汤对照组比较,黄连汤组28、90天生存率差异无统计学意义(P>0.05)。结论 黄连汤“昼三夜二”分时给药可以Objective To observe the clinical efficacy of taking Huanglian Decoction(HD)thrice by day and twice by night on sepsis-related acquired weakness.Methods Sixty patients with sepsis-related acquired weakness in department of intensive care unit(ICU),the second affiliated hospital of Nanjing University of Chinese Medicine from January 2023 to May 2024 were enrolled in this study and randomly assigned to into control group,HD group and HD control group,with 20 cases in each group.All three groups were given the conventional nutritional support program,the HD group took HD thrice by day and twice by night,and the HD control group was given HD twice in the morning and evening,and the treatment lasted for 14 days.Biceps brachii muscle thickness,rectus femoris muscle thickness,diaphragmatic excursion,and diaphragmatic thickening fraction were measured before and after treatment.Serum hemoglobin,albumin,and prealbumin levels were measured.The 28 d and 90 d survival rates for each group of patients were calculated.Results Totally 2 cases dropped out in HD group,and 1 case dropped out in HD control group.Compared with the group before treatment,rectus femoris muscle thickness,diaphragmatic excursion in 7 d of treatment,biceps brachii muscle thickness,rectus femoris muscle thickness,diaphragmatic excursion,and diaphragmatic thickening fraction in 7 d and 14 d of treatment,serum albumin,and prealbumin levels in 14 d of treatment increased in control group and HD control group(P<0.05).Biceps brachii muscle thickness,rectus femoris muscle thickness,diaphragmatic excursion,and diaphragmatic thickening fraction in 7 d and 14 d of treatment,serum albumin,and prealbumin in 14 d of treatment increased in HD group(P<0.05).Compared with the control group at the same time,rectus femoris muscle thickness,serum hemoglobin and prealbumin in 14 d of treatment,diaphragmatic excursion in 7 d and 14 d of treatment increased in HD control group(P<0.05).Biceps brachii muscle thickness,rectus femoris muscle thickness,diaphragmatic excursion,and

关 键 词：黄连汤 昼三夜二 分时给药 脓毒症 获得性衰弱 中药复方 中西医结合 随机对照试验 

分 类 号：R278[医药卫生—中医学]