摘要
目的 探讨加味承气汤对脑卒中胃肠功能障碍患者实施肠内营养(EN)的临床疗效.方法 选择2017年12月至2019年12月在浙江省长兴县中医院住院治疗的脑卒中胃肠功能障碍患者120例,随机分为对照组和试验组,每组60例.对照组采用西医常规治疗〔包括保护脑功能,护胃,鼻饲(按照2006欧洲肠内肠外营养指南推荐的方法给予标准的胃肠营养方案)〕;试验组在对照组治疗基础上加味承气汤.两组10 d为1个疗程,观察两组治疗前及治疗5 d和10 d营养状态指标白蛋白(ALB)、前白蛋白(PAB)、血红蛋白(Hb)及肠黏膜屏障功能指标内毒素(ET)、二胺氧化酶(DAO)、肠鸣音、重症监护病房(ICU)住院天数和肠鸣音变化情况.结果 治疗前两组各项营养状态指标、肠黏膜屏障功能指标和肠鸣音比较差异均无统计学意义(均P>0.05).治疗5 d和10 d后两组ALB、PAB、Hb水平均较治疗前明显升高,且试验组明显高于对照组,以治疗10 d时更为显著〔ALB(g/L):39.02±0.83比35.56±0.49,PAB(mg/L):313.7±8.9比265.5±7.3,Hb(g/L):119.43±1.45比109.63±2.48,均P<0.05〕;治疗5 d和10 d两组ET、DAO水平均较治疗前降低,且试验组明显低于对照组,以治疗10 d时更为显著〔ET(EU/L):280±10比360±20,DAO(kU/L):2.22±0.10比3.01±0.41,均P<0.05〕;治疗5 d和10 d两组肠鸣音次数均明显增多,且试验组明显多于对照组,以治疗10 d时更为显著(次/min:5.23±0.72比3.30±0.46,P<0.05);两组ICU住院天数比较差异无统计学意义(P>0.05).结论 加味承气汤改善了脑卒中患者的胃肠功能状态,提高了营养支持治疗效果,对脑卒中胃肠功能障碍实施EN取得了良好疗效.
ObjectiveTo explore the clinical effect of modified Chengqi Decoction and enteral nutrition(EN)in patients with gastrointestinal dysfunction after stroke.Methods One hundred and twenty patients with gastrointestinal dysfunction afer stroke hospitalized in Changxing County Hospital of Tradional Chinese Medicine(TCM)in Zhejiang Province from December 2017 to December 2019 were randomly divided into a control group and an experimental group,with 60 cases in each group.The control group was treated with conventional Western medicine,including brain function protection,stomach protection and nasal feeding(standard gastrointestinal nutrition scheme was given according to the method recommended by the 2006 European guidelines for enteral and parenteral nutrition);the experimental group was treated with modified Chengqi Decoction on the basis of the control group treatment.Both groups were treated in a 10-day course.The changes of nutritional status indexes[albumin(ALB),prealbumin(PAB),hemoglobin(Hb)],intestinal mucosal barrier function indexes[endotoxin(ET),diamine oxidase(DAO),and bowel sounds before and 5 and 10 days after treatment as well as intensive care unit(ICU)stay days were observed and compared between the two groups.Results The indexes of nutritional status and intestinal mucosal barrier functions,as well as the bowel sounds of two groups were of no statistical significant differences before treatment(all P>0.05).The levels of ALB,PAB and Hb were increased dramatically after treatment for 5 and 10 days in both groups,and the levels in the experimental group were obviously higher than those of the control group,especially the differences being more statistically significant after 10 days of treatment[ALB(g/L):39.02±0.83 vs.35.56±0.49,PAB(mg/L):313.7±8.9 vs.265.5±7.3,Hb(g/L):119.43±1.45 vs.109.63±2.48,ll P<0.05];the levels of ET and DA0 in the experimental group were significantly lower than those in the control group after treatment for 5 and 10 days,especially afer 10 days of treatment the dfferences b
作者
潘长林
李海峰
Pan Changlin;Li Haifeng(Department of Critical Medicine,Changxing County Hospital of Traditional Chinese Medicine,Huzhou 313100,Zhejang,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2022年第3期339-342,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省湖州市科技局公益性应用研究项目(2017CY72)。
关键词
加味承气汤
脑卒中
胃肠功能障碍
肠内营养
Modified chengqi decoction
Stroke
,Gastrointestinal dysfunction
Enteral nutrition
