首页|补中益气汤治疗脾气虚证机械通气重症监护病房获得性衰弱患者36例临床观察

补中益气汤治疗脾气虚证机械通气重症监护病房获得性衰弱患者36例临床观察

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目的 观察补中益气汤对脾气虚证机械通气重症监护病房获得性衰弱(ICU-AW)患者的疗效及安全性.方法 将72例脾气虚证机械通气ICU-AW患者随机分为对照组和治疗组各36例.对照组给予常规ICU基础治疗和护理并联合生理盐水鼻饲或口服(每日3次、每次50 ml),治疗组给予常规ICU基础治疗和护理并联合补中益气汤鼻饲或口服(每日3次、每次50 ml),治疗周期均为7天.在治疗前后分别评估患者中医证候积分、英国医学研究理事会(MRC)评分、膈肌移动度、吸气末及呼气末膈肌厚度、膈肌增厚率、脱机拔管成功时间、超氧化物歧化酶(SOD)及丙二醛(MDA)水平,并评估中医证候疗效.结果 治疗组中医证候疗效总有效率为88.89%,高于对照组的66.67%(P=0.033).与治疗前比较,治疗后两组患者中医证候主症积分、次症积分、总积分、膈肌移动度、MDA均较治疗前减少,MRC评分、膈肌增厚率、SOD均较治疗前增加(P<0.01),且治疗组上述各指标改善均优于对照组(P<0.05或P<0.01).治疗组在治疗后7天内成功拔除气管插管例数(28例/36例,77.78%)高于对照组(19例/36例,52.78%).结论 基础治疗联合补中益气汤口服可以提高脾气虚证机械通气ICU-AW患者的MRC评分,改善全身状态,增强膈肌收缩,增强抗氧化能力,提高拔管成功率,且安全性较好.
Observation on the Effect of Buzhong Yiqi Decoction(补中益气汤)in the Treatment of 36 Mechanically Ventilated Cases of ICU-acquired Weakness with Spleen Qi Deficiency Syndrome
Objective To analyze the efficacy and safety of Buzhong Yiqi Decoction(补中益气汤,BYD)in the treatment of mechanically ventilated patients of intensive care unit acquired weakness(ICU-AW)with spleen qi defi-ciency syndrome.Methods Seventy-two patients eligible for mechanical ventilation ICU-AW and spleen qi deficiency were selected and randomly divided into routine ICU basic treatment and nursing combined with nasal feeding or oral administration of normal saline 3 times a day,50 ml per time as control group,and routine ICU basic treatment and nursing combined with BYD 3 times a day,50 ml per time as treatment group,with 36 cases in each group.The treatment cycle was 7 days.Traditional Chinese medicine(TCM)syndrome score,Medical Research Council(MRC)score,diaphragm mobility,diaphragm thickness at the end of inspiration and expiration,diaphragm thickness rate,time to successfully remove the tracheal tube,superoxide dismutase(SOD)and malondialdehyde(MDA)levels of patients were measured before and after treatment,and the efficacy of TCM syndrome was evaluated.Results The total effective rate regarding TCM syndrome was 88.89%in the treatment group,which was higher than 66.67%in the control group(P=0.033).After treatment,the main symptom score,secondary symptom score and total score of TCM syndrome,diaphragm mobility and MDA level significantly decreased in both groups,while MRC score,dia-phragm thickness rate and SOD level increased(P<0.01),with more improvement in the treatment group than in the control group(P<0.05 or P<0.01).The number of successful tracheal intubation removal within 7 days after treat-ment in the treatment group(28/36 cases,77.78%)was higher than that in the control group(19/36 cases,52.78%).Conclusion Basic treatment combined with oral administration of BYD can improve the MRC score,general condition,diaphragm contraction,and antioxidant capacity of patients with mechanical ventilation in ICU-AW with spleen qi deficiency,thereby improving the success rate of extubation with sound safety.

intensive care unit acquired weaknessspleen qi deficiencyBuzhong Yiqi Decoction(补中益气汤)Medical Research Council-scorediaphragm excursionserum oxidation levels

伍柏灵、谭旭宏、胡永胜

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贵州中医药大学第二附属医院,贵州省贵阳市云岩区飞山街83号,550001

重症监护病房获得性衰弱 脾气虚 补中益气汤 英国医学研究理事会评分 膈肌移动度 血清氧化水平

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(23)