CAJ | 학술논문

目的探讨益气健脾中药联合肠内营养剂对危重症机械通气患者营养的影响.方法 60例危重症机械通气患者,完全随机分为对照组和试验组,各30例.对照组采用常规肠内营养剂,试验组在常规肠内营养剂基础上加用益气健脾中药(四君子汤),分别在治疗前和治疗5、10 d记录患者总蛋白、白蛋白、前白蛋白、血红蛋白等营养学指标和主要安全性指标.结果总蛋白:试验组治疗10 d后与治疗前和对照组同期比较,差异均有统计学意义[(65±4)g/L比(56±5)g/L,(61±6)g/L,均P＜0.05].白蛋白:试验组治疗5和10 d与治疗前比较差异有统计学意义[(31.8±2.6)g/L,(35.2±3.0)g/L比(30.0 ±2.8)g/L,均P＜0.05]；且治疗10 d时与对照组[(31.9±4.2)g/L]比较差异有统计学意义(P＜0.05).前白蛋白:试验组治疗10d时与治疗前和对照组同期比较差异有统计学意义[(276±58) g/L比(204±51 )g/L,(213±48) g/L,均P＜0.05].血红蛋白:在对照组和试验组治疗后均有升高趋势,但与治疗前比较差异无统计学意义(P＞0.05).2组治疗前后主要安全性指标差异均无统计学意义(均P ＞0.05).结论机械通气的危重症患者存在营养不良,通过单纯的肠内营养可能不改善患者营养不良的状况,而在常规肠内营养基础之上,添加四君子汤通过益气健脾可能改善其营养不良状况.
목적 탐토익기건비중약연합장내영양제대위중증궤계통기환자영양적영향.방법 60례위중증궤계통기환자,완전수궤분위대조조화시험조,각30례.대조조채용상규장내영양제,시험조재상규장내영양제기출상가용익기건비중약(사군자탕),분별재치료전화치료5、10 d기록환자총단백、백단백、전백단백、혈홍단백등영양학지표화주요안전성지표.결과 총단백:시험조치료10 d후여치료전화대조조동기비교,차이균유통계학의의[(65±4)g/L비(56±5)g/L,(61±6)g/L,균P＜0.05].백단백:시험조치료5화10 d여치료전비교차이유통계학의의[(31.8±2.6)g/L,(35.2±3.0)g/L비(30.0 ±2.8)g/L,균P＜0.05]；차치료10 d시여대조조[(31.9±4.2)g/L]비교차이유통계학의의(P＜0.05).전백단백:시험조치료10d시여치료전화대조조동기비교차이유통계학의의[(276±58) g/L비(204±51 )g/L,(213±48) g/L,균P＜0.05].혈홍단백:재대조조화시험조치료후균유승고추세,단여치료전비교차이무통계학의의(P＞0.05).2조치료전후주요안전성지표차이균무통계학의의(균P ＞0.05).결론 궤계통기적위중증환자존재영양불량,통과단순적장내영양가능불개선환자영양불량적상황,이재상규장내영양기출지상,첨가사군자탕통과익기건비가능개선기영양불량상황.
Objective To explore the method of replenishing qi to invigorate spleen combined with enteral nutrition therapy in patients with mechanical ventilation.Methods Sixty cases of critically patients with mechanical ventilation who came from the Qingdao Hiser Hospital of ICU from January 2010 to October 2011 were chosen.According to the unified criteria of patients selection,the control group received enteral nutrition only and the experiment group received enteral nutrition combined with the traditional Chinese medicine to Replenish qi to invigorate spleen.Nutritional markers (total protein,albumin,preabumin,hemoglobin)in two groups on the first day before the nourishment therapy,fifth day and tenth day after treatment were detected.Results Total protein in experimental group after 10 d treatment had significant differences compared with before treatment and control group [ (65±4)g/L vs (56±5)g/L,(61±6)g/L,P ＜0.05].Albumin in experimental group treated with 5 d and 10 d had significant differences compared with before treatment [ (31.8±2.6)g/L,(35.2±3.0)g/L vs (30.0±2.8 )g/L,all P＜0.05 ];after 10 d treatment there was a significant difference between experimental group and control group [ (35.2±3.0)g/L vs (31.9±4.2 )g/L,P＜0.05 ].Pre-albumin in experimental group after 10 d treatment had significant differences compared with before treatment and control group [ (276±58 )g/L,(204±51 )g/L vs (213±48)g/L,P＜0.05].The difference of hemoglobin was not statistically significant in the control group and the experimental group after treatment (P ＞ 0.05 ).There were no significant differences in the main safety indexes between 2 groups before and after treatment (P ＞ 0.05 ). Conclusion Chinese medicine of replenishing qi to invigorate spleen therapy combined with enteral nutrition is superior to enteral nutrition only,and it can improve malnutrition in patients with mechanical ventilation.