摘要
目的探讨四君子汤加减联合肠内营养支持对脑卒中后吞咽障碍患者营养状态及免疫功能的影响。方法将2020年5月-2021年12月南京医科大学康达学院第一附属医院收治的脑卒中后吞咽障碍患者180例,根据随机数表法分对照组与观察组,各90例。对照组给予肠内营养支持治疗,观察组在对照组基础上给予四君子汤加减治疗,2组均治疗2周。比较2组治疗前后营养状况、免疫功能,胃肠功能恢复及康复情况,治疗过程中并发症发生情况。结果与治疗前比较,治疗后2组血清前白蛋白(PA)、总蛋白(TP)、上臂三头肌肌围(MAMC)水平均降低,观察组高于对照组(P<0.05);与治疗前比较,治疗后2组血清免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平均升高,观察组高于对照组(P<0.05);观察组肠鸣音恢复、首次排气、平均住院时间短于对照组(P<0.05);与治疗前比较,治疗后2组美国国立卫生研究院卒中量表(NIHSS)评分均降低,且观察组在2组中更低(P<0.05);治疗过程中,观察组并发症发生率在2组中更低(P<0.05)。结论四君子汤联合肠内营养支持可改善脑卒中后吞咽障碍患者营养状态及免疫功能,促进胃肠道功能恢复及神经功能康复,同时降低并发症发生率,值得临床进一步研究与应用。
Objective To analyze the eff ect of modifi ed Sijunzi decoction combined with enteral nutrition support on nutritional status and immune function in patients with dysphagia after stroke.Methods From May 2020 to December 2021,180 patients with dysphagia after stroke admitted to The First Affi liated Hospital of Kangda College of Nanjing Medical University were enrolled and divided into the control group and the observation group according to random number table method,with 90 cases in each group.The control group received enteral nutrition support treatment,the observation group was given Sijunzi decoction on the basis of treatment in the control group,and both groups were treated for 2 weeks.The nutritional status,immune function before and after 2 weeks of treatment,gastrointestinal function recovery and rehabilitation,and complications during the treatment were compared between 2 groups.Results Compared with before treatment,after 2 weeks of treatment the serum levels of prealbumin(PA),total protein(TP),and mid-arm muscle circumference(MAMC)in 2 groups decreased,but the observation group was higher than the control group(P<0.05).Compared with before treatment,after 2 weeks of treatment,the serum levels of immunoglobulin G(IgG)and immunoglobulin A(IgA)in both groups increased,and the observation group was higher than the control group(P<0.05).The recovery of bowel sounds,the fi rst fl atus,and the average hospital stay in the observation group were shorter than those in the control group(P<0.05).Compared with before treatment,after treatment,the scores of national institutes of health stroke scale(NIHSS)in 2 groups decreased,and the observation group was lower in 2 groups(P<0.05).During the treatment,the incidence of complications in the observation group was lower in the two groups(P<0.05).Conclusion Sijunzi decoction combined with enteral nutrition support may improve the nutritional status and immune function of patients with dysphagia after stroke,promote the recovery of gastrointestinal function and neurolo
作者
李文丽
沈德嫱
易海维
LI Wenli;SHEN Deqiang;YI Haiwei(Department of Clinical Nutrition,the First Affiliated Hospital of Kangda College,Nanjing Medical University,Lianyungang 222000,China)
出处
《长春中医药大学学报》
2023年第5期519-522,共4页
Journal of Changchun University of Chinese Medicine
基金
连云港市第一人民医院青年英才基金项目(QN202003)。
关键词
脑卒中
吞咽障碍
四君子汤
肠内营养
营养状况
免疫功能
胃肠功能
stroke
dysphagia
Sijunzi decoction
enteral nutrition
nutritional status
immune function
gastrointestinal function
