补中益气汤合小柴胡汤治疗机械通气重症监护室获得性衰弱患者的临床疗效观察

Observation on therapeutic effect of Buzhong Yiqi Decoction combined with Xiaochaihu Decoction on ICU acquired frailty in patients with mechanical ventilation

关键词:  重症监护室获得性衰弱  机械通气  疲劳  运动耐力  日常生活能力  补中益气汤  小柴胡汤

Key words:  intensive care unit acquired weakness  mechanical ventilation  fatigue  exercise endurance  ability of daily living  Buzhong Yiqi Decoction  Xiaochaihu Decoction

摘要:

[目的] 探讨补中益气汤合小柴胡汤治疗机械通气重症监护室获得性衰弱（ICU-AW）的疗效。[方法] 选择2019年10月—2022年10月河北省沧州中西医结合医院收治的82例行机械通气治疗的重症监护室获得性衰弱（ICU-AW）患者，随机数字表法将患者分为两组，每组各41例。对照组给予常规治疗，观察组在对照组基础上给予补中益气汤合小柴胡汤治疗14 d。比较两组疗效、机械通气时间、ICU住院时间、下床活动时间、中医证候积分、衰弱、肌力状态、运动耐力、日常生活能力以及并发症和不良反应差异。[结果] 观察组治疗总有效率高于对照组（95.12% vs. 73.17%，P＜0.05），机械通气时间、重症监护室（ICU）住院时间、下床活动时间短于对照组（P＜0.01），6 min步行距离、Barthel指数（BI）指数高于对照组（P＜0.05），Borg评分、呼吸机相关性肺炎发生率低于对照组（P＜0.05）。两组治疗后体倦乏力、食欲不振、胁胀作痛、情志抑郁、面色萎黄积分、心血管健康研究指数（CHS）评分均较治疗前降低（P＜0.01），医学研究委员会（MRC）评分较治疗前增高（P＜0.01），观察组治疗后上述中医证候积分、CHS评分低于对照组（P＜0.01），MRC评分高于对照组（P＜0.01）。[结论] 与常规治疗比较，补中益气汤合小柴胡汤更有助于改善衰弱和疲劳症状，提高运动耐力和日常生活能力，临床疗效更显著。

Abstract:

[Objective] To investigate the therapeutic effect of Buzhong Yiqi Decoction combined with Xiaochaihu Decoction on mechanical ventilation intensive care unit acquired frailty（ICU-AW）. [Methods] From October 2019 to October 2022，82 patients with mechanical ventilation intensive care unit acquired frailty（ICU-AW） treated in our hospital were selected and divided into two groups by random number table method，with 41 cases in each group. The control group was given routine treatment，and the observation group was given Buzhong Yiqi Decoction combined with Xiaochaihu Decoction for 14 days on the basis of the control group. The therapeutic effect，mechanical ventilation time，ICU stay，ambulation time，traditional Chinese medicine（TCM） syndrome score，frailty，muscle strength status，exercise endurance，daily living ability，complications and adverse reactions were compared between the two groups. [Results] The total effective rate of the observation group was higher than that of the control group（95.12% vs 73.17%，P＜0.05），the mechanical ventilation time，ICU stay time，ambulation time were shorter than those of the control group（P＜0.01），the 6 min walking distance and Barthel index（BI） were higher than those of the control group（P＜0.05）. The Borg score and the incidence of ventilator-associated pneumonia were lower than those of the control group（P＜0.05）. After treatment，fatigue，loss of appetite，pain，emotional depression，complexion atrophic score and CHS score in the two groups were lower than those before treatment（P＜0.01），and MRC score was higher than that before treatment（P＜0.01）. After treatment，the TCM syndrome score and CHS score in the observation group were lower than those in the control group（P＜0.01）. The MRC score was higher than that of the control group（P＜0.01）. [Conclusion] Compared with conventional treatment，Buzhong Yiqi Decoction combined with Xiaochaihu Decoction is more helpful to improve the frailty and fatigue symptoms，and enhance the exercise endurance and daily living ability. The clinical effect is more significant.