摘要
目的探讨中药参苓白术散联合肠内营养对危重病患者预后的影响。方法采用多中心、随机、对照、双盲的方法,将四家医院纳入的220例危重症患者分为治疗组(112例)和对照组(108例),两组均给予西医常规治疗,治疗组在此基础上给予参苓白术散颗粒(10 g/袋),每次1袋,口服或经胃管鼻饲,每日4次,对照组给予等量安慰剂治疗,疗程至转出ICU。观察两组患者入ICU后新发感染率、呼吸机带机时间、ICU住院时间和治疗前后急性生理与慢性健康(APACHEⅡ)评分、血红蛋白、白蛋白、前白蛋白水平。比较两组胃肠营养耐受情况和病死率。结果与本组治疗前比较,两组治疗后前白蛋白、白蛋白水平差异有统计学意义(P<0.05),治疗组APACHEⅡ评分降低(P<0.05)。治疗后与对照组比较,治疗组前白蛋白、白蛋白水平升高(P<0.05),治疗组呼吸机带机时间、ICU住院时间、APACHEⅡ评分、胃肠营养不耐受发生率均明显减少(P<0.05)。两组入ICU后新发感染的发生率及病死率比较,差异无统计学意义(P>0.05)。结论参苓白术散可改善危重病患者肠内营养的耐受性,提高患者血浆白蛋白水平,改善患者营养状态,缩短机械通气时间。
Objective To observe the effect of Shenling Baizhu Powder on the prognosis of critically ill patients with enteral nutrition.Methods A multicenter,randomized,controlled,double-blind clinical trial was performed.Totally 220 patients with critically ill in four hospitals were enrolled and assigned to treatment group(112 cases)and control group(108 cases).All patients received routine treatment.Patients in the treatment group received Shenling Baizhu Powder additionally,one package each time,oral or by gastric tube administration,4 times a day.Those in the control group took equal amount of placebo,the therapeutic course for transferred out of ICU.The new infection rate after ICU admission,duration of mechanical ventilation,ICU period and APACHEⅡScore,hemoglobin,albumin,and prealbumin levels were observed before and after treatment.The nutritional tolerance and mortality were compared between the two groups.Results Compared with before treatment in the same group,there was statistical difference in prealbumin and albumin levels between the two groups after treatment(P<0.05).The APACHEⅡscore was lower after treatment in the treatment group(P<0.05).Compared with the control group,the levels of prealbumin and albumin in the treatment group were increased(P<0.05).The duration of mechanical ventilation,ICU period,APACHEⅡscore and the incidence of gastrointestinal nutritional intolerance in the treatment group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the new infection rate after ICU admission and mortality between the two groups(P>0.05).Conclusion Shenling Baizhu Powder could improve the tolerance of enteral nutrition in critically ill patients,improve the level of plasmaalbumin,improve the nutritional status of patients,shorten the time of mechanical ventilation.
作者
王春霞
高培阳
韩宽怀
朱静
余利军
徐吕
WANG Chun-xia;GAO Pei-yang;HAN Kuan-huai;ZHU Jing;YU Lijun;XU Lyu(Intensive Care Unit,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072;Intensive Care Unit,Xindu Hospital of Traditional Chinese Medicine,Chengdu 610500;Intensive Care Unit,Suining Hospital of Traditional Chinese Medicine,Sichuan629000;Intensive Care Unit,Ziyang Hospital of Traditional Chinese Medicine,Sichuan 641300)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2020年第1期41-45,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
四川省中医药管理局中医药科学技术研究专项项目(No.CKY2016031)
关键词
参苓白术散
肠内营养
危重病
Shenling Baizhu Powder
enteral nutrition
critically ill
