肝胃百合汤对脑卒中肠内营养患者胃肠道反应的影响
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摘要
目的:探讨肝胃百合汤对脑卒中肠内营养患者胃肠道反应的影响。方法:选择72例脑卒中肠内营养患者为研究对象,以随机数字表法分为对照组与观察组各36例,对照组采用常规肠内营养制剂进行营养支持,观察组在对照组基础上给予肝胃百合汤,对两组患者胃肠道反应发生率及神经功能、营养状态进行观察。结果:观察组患者胃潴留、便秘、腹泻、反流、呕吐等并发症发生率为19.44%,明显低于对照组55.56%,差异有统计学意义(P<0.05);观察组NIHSS评分与GCS评分优于对照组(P<0.05);观察组血红蛋白、血清白蛋白及血清前白蛋白等营养指标明显优于对照组(P<0.05)。观察组免疫功能优于对照组,其IgA、IgG、IgM等指标明显高于对照组(P<0.05)。结论:肝胃百合汤能减少脑卒中肠内营养患者胃肠道反应发生率,提高机体营养状态、免疫功能,也利于神经功能恢复,值得临床应用。
Objective:To explore the effect of Ganwei Baihe decoction on gastrointestinal reaction in patients with cerebral apoplexy enteral nutrition.Methods:72 stroke patients with enteral nutrition were divided into control group and observation group by random number table method,36 cases in each group.The control group was given routine enteral nutrition preparation for nutritional support.The observation group was given Ganwei Baihe decoction on the basis of the control group.The state of feeding was observed.Results:The incidence of gastric retention,constipation,diarrhea,reflux,vomiting and other complications in the observation group was 19.44%,significantly lower than 55.56%in the control group(P<0.05);the NIHSS score and GCS score in the observation group were better than those in the control group(P<0.05).the hemoglobin,serum albumin and serum prealbumin in the observation group were better than those in the control group(P<0.05)And other nutritional indicators were significantly better than those in the control group(P< 0.05).The immune function of the observation group was better than that of the control group,and the indicators such as IgA,IgG and IgM were significantly higher than those of the control group(P<0.05).Conclusion:Ganwei Baihe decoction can reduce the incidence of gastrointestinal reactions in patients with enteral nutrition after stroke,improve the nutritional status of the body andimmune function,,but also conducive to the recovery of nerve function,worthy of clinical promotion.
Objective:To explore the effect of Ganwei Baihe decoction on gastrointestinal reaction in patients with cerebral apoplexy enteral nutrition.Methods:72 stroke patients with enteral nutrition were divided into control group and observation group by random number table method,36 cases in each group.The control group was given routine enteral nutrition preparation for nutritional support.The observation group was given Ganwei Baihe decoction on the basis of the control group.The state of feeding was observed.Results:The incidence of gastric retention,constipation,diarrhea,reflux,vomiting and other complications in the observation group was 19.44%,significantly lower than 55.56%in the control group(P<0.05);the NIHSS score and GCS score in the observation group were better than those in the control group(P<0.05).the hemoglobin,serum albumin and serum prealbumin in the observation group were better than those in the control group(P<0.05)And other nutritional indicators were significantly better than those in the control group(P< 0.05).The immune function of the observation group was better than that of the control group,and the indicators such as IgA,IgG and IgM were significantly higher than those of the control group(P<0.05).Conclusion:Ganwei Baihe decoction can reduce the incidence of gastrointestinal reactions in patients with enteral nutrition after stroke,improve the nutritional status of the body andimmune function,,but also conducive to the recovery of nerve function,worthy of clinical promotion.
引文
[1]王宝艳,刘刚,刘永宏,等.缺血性脑血管疾病发病相关因素调查研究[J].陕西医学杂志,2018,47(9):1210-1212.
[2]山林林,王玉龙,张思为,等.肝胃百合汤对卒中后肠内营养患者营养状态、免疫功能及神经功能的影响[J].包头医学院学报,2017,33(12):102-104.
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[5]林丹,肖永红.免疫肠内营养支持治疗对重症脑卒中患者营养状况、免疫功能及预后的影响[J].江苏医药,2018,44(7):811-814.
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[8]王伟.肝胃百合汤治疗胃溃疡肝胃不和证的临床效果[J].中医临床研究,2016,8(26):24-25.
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[11]谭华梁,肖麟.肝胃百合汤治疗功能性消化不良肝胃不和证患者的临床观察及对CCK的影响[J].中医临床研究,2014,6(1):22-24.
[12]李敏,高凯,王华林,等.柴胡皂苷d-黄芩苷配伍对CCl_4诱导大鼠HSC的TLR4-NF-κB通路作用研究[J].陕西中医,2018,39(1):3-5.
[13]罗林明,裴刚,覃丽,等.中药百合化学成分及药理作用研究进展[J].中药新药与临床药理,2017,28(6):824-837.
[14]马玉红,刘玉华,马守成,等.丹参粉针对大鼠应激性溃疡胃黏膜保护作用的实验研究[J].宁夏医科大学学报,2017,39(4):425-428.
[15]戴金锋,金海峰,孟立娜,等.郁金及三七治疗慢性萎缩性胃炎的多中心随机临床研究[J].现代中医临床,2017,24(6):15-19.
[16]郑怀仓.肝胃百合汤合黄连温胆汤治疗胆汁反流性胃炎80例[J].青海医药杂志,2011,41(8):82-83.
[17]孟军鹏,尤雪梅,赵佩,等.影响脑卒中患者发生记忆功能障碍的相关危险因素分析[J].陕西医学杂志,2018,47(1):41-43.
[18]李文玉,吴晓峰,付洁,等.麝香郁金汤对缺血性脑卒中患者炎性因子及D-二聚体的影响[J].陕西中医,2017,38(9):1164-1165.
[2]山林林,王玉龙,张思为,等.肝胃百合汤对卒中后肠内营养患者营养状态、免疫功能及神经功能的影响[J].包头医学院学报,2017,33(12):102-104.
[3] WanXiao,Gao Xuejin,Tian Feng,et al.Early parenteral nutrition alone or accompanying enteral nutrition in critically ill patients:a systematic review and meta-analysis[J].Asia Pacific journal of clinical nutrition,2015,24(2):227-233.
[4]戴克银,彭晓林.老年脑卒中伴吞咽障碍患者营养干预效果及预后影响因素[J].中国老年学杂志,2018,38(6):1286-1288.
[5]林丹,肖永红.免疫肠内营养支持治疗对重症脑卒中患者营养状况、免疫功能及预后的影响[J].江苏医药,2018,44(7):811-814.
[6]张平国.脑卒中患者应用早期肠内营养治疗的疗效分析[J].上海医药,2018,39(2):21-22.
[7]张思为,周志,山林林,等.肝胃百合汤对脑卒中患者肠内营养胃肠道并发症及营养状态的影响[J].中医学报,2017,32(12):2464-2468.
[8]王伟.肝胃百合汤治疗胃溃疡肝胃不和证的临床效果[J].中医临床研究,2016,8(26):24-25.
[9] Gungabissoon U,Hacquoil,K,Bains C,et al.Prevalence,Risk Factors,Clinical Consequences,and Treatment of Enteral Feed Intolerance During Critical Illness[J].JPEN,2015,39(4):441-448.
[10]郝亮,孟国奇,马荣.肝胃百合汤加减治疗消化道溃疡100例临床观察[J].山西中医学院学报,2014,15(6):66-67.
[11]谭华梁,肖麟.肝胃百合汤治疗功能性消化不良肝胃不和证患者的临床观察及对CCK的影响[J].中医临床研究,2014,6(1):22-24.
[12]李敏,高凯,王华林,等.柴胡皂苷d-黄芩苷配伍对CCl_4诱导大鼠HSC的TLR4-NF-κB通路作用研究[J].陕西中医,2018,39(1):3-5.
[13]罗林明,裴刚,覃丽,等.中药百合化学成分及药理作用研究进展[J].中药新药与临床药理,2017,28(6):824-837.
[14]马玉红,刘玉华,马守成,等.丹参粉针对大鼠应激性溃疡胃黏膜保护作用的实验研究[J].宁夏医科大学学报,2017,39(4):425-428.
[15]戴金锋,金海峰,孟立娜,等.郁金及三七治疗慢性萎缩性胃炎的多中心随机临床研究[J].现代中医临床,2017,24(6):15-19.
[16]郑怀仓.肝胃百合汤合黄连温胆汤治疗胆汁反流性胃炎80例[J].青海医药杂志,2011,41(8):82-83.
[17]孟军鹏,尤雪梅,赵佩,等.影响脑卒中患者发生记忆功能障碍的相关危险因素分析[J].陕西医学杂志,2018,47(1):41-43.
[18]李文玉,吴晓峰,付洁,等.麝香郁金汤对缺血性脑卒中患者炎性因子及D-二聚体的影响[J].陕西中医,2017,38(9):1164-1165.