| Objective:This study from the prevention and improvement of angle engenders pill Decoction early enteral nutrition feeding intolerance of hope to improve the current status of early enteral nutrition feeding intolerance through the methods of traditional Chinese medicine,improve their feeding efficiency,promote gastrointestinal function recovery and reduce adverse outcomes caused by gastrointestinal dysfunction at the same time,to explore new ideas in Chinese medicine in critically ill patients with early enteral nutrition in the field.Methods:this study selected 30 patients hospitalized from November 2017 to February 2018 in Beijing city in a grade Ⅲ-A hospital surgical ICU,according to a randomized,controlled and single blind principle respectively for the test group and the control group with 15 cases in each group,the experimental group was 1 cases,the control group fall off in 2 cases,including the death of in 1 cases.Two groups of patients were given western medicine standardized treatment,the experimental group used engenders pill decoction combined with early enteral nutrition,the control group was given early enteral nutrition and the equivalent temperature of boiling water for 7 days.The incidence of the two groups of patients before and after treatment of feeding intolerance in first,third,seventh days,two groups of patients with feeding intolerance score,nutrition and enteral compliance days compliance rate,vomiting,diarrhea,constipation,abdominal pressure is greater than or equal to 3 points and the incidence of hospitalization,two groups of patients nutritional indexes:serum albumin(ALB),transferrin(TF),prealbumin(PA)index,immune index:immunoglobulin(IgA,IgG,IgM),T lymphocyte subsets(CD3+,CD4+,CD8+),white blood cell count(N),inflammatory reaction index:procalcitonin(PCT)and C-reactive protein(CRP).Safety index:alanine aminotransferase(ALT)and aspartate aminotransferase(AST),total bilirubin(TBIL),creatinine(CR),urea nitrogen(BUN)were analyzed.If the measurement data obey the normal distribution,the paired sample t test is used to compare the variance analysis between the two groups.The independent sample t test is used.If the normal distribution is not followed,two independent samples nonparametric test is used.Results:the incidence of feeding intolerance in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(P=0.028<0.05).The first day(D1)two groups had no statistically significant differences in scores between the feeding tolerance test(P=0.496>0.05);third days(D3)experimental group feeding tolerance score lower than the control group,but the difference between the two groups was not statistically significant(P=0.054>0.05),can be seen in experimental group than the control group feeding tolerance score decreased significantly the trend test for seventh days;(D7)experimental group feeding tolerance score lower than the control group,the difference was statistically significant(P=0.002<0.05),can be seen in experimental group than in the control group feeding tolerance scores were significantly decreased.The experimental group of early enteral nutrition compliance rate is higher than the control group,the difference was statistically significant(2=8.09,P=0.004<0.05),that engenders pill decoction can increase the compliance rate of early enteral nutrition,enteral nutrition feeding amount increased.The test group,vomiting and diarrhea incidence of bladder pressure is greater than or equal to 3 points lower than in the control group,the difference was statistically significant(2=5.26,10.71,8.09,P=0.022,0.001,0.004<0.05),the incidence of constipation in experimental group than the control group,the difference was not statistically significant(2=0.40,P=0.525>0.05).Two groups of indicators of nutritional status before treatment had no significant difference between the groups(P>0.05);test group ALB,PA,TF and other nutritional indexes were increased compared with the control group before and after treatment group,contrast group differences were statistically significant(P<0.05);experimental group and control group after treatment compared with ALB,PA,TF the nutrition index increased more obviously,and there was significant difference between two groups(P<0.05);inflammatory indexes before the treatment there was no significant difference between the groups(P>0.05);compared to the experimental group and the control group before and after treatment in group CRP,PCT and other inflammatory index decreased,there was statistically significant difference compared to group(P<0.05);the control group and the experimental group after treatment,CRP after treatment,PCT index decreased significantly,but no significant difference(P>0.05).Two groups of immune indexes before treatment had no significant difference between the groups(P>0.05);the experimental group before and after treatment group compared with IgA,IgM,IgG,CD3+,CD4+,C48+,N and other immune indexes were increased,the difference was statistically significant(P<0.05);the control group before and after treatment group compared to IgA,IgM,IgG,CD3+ CD4+,C48+ and N were decreased,except IgM the difference was statistically significant(P<0.05);the experimental group after treatment IgA,IgM,IgG,CD3+,CD4+,C48+,N were significantly higher compared with control group after treatment,there were statistically significant differences between the groups(P<0.05).There was no significant difference in safety indexes such as ALT,AST,TBIL,CR and BUN in the test group before and after treatment,and the difference was not statistically significant(P>0.05).Conclusion:the decoction engenders pill can effectively improve the feeding intolerance in critically ill patients,reduce the incidence of feeding intolerance,and with the treatment time growth effect is obvious;the decoction can increase nutrition engenders pill enteral feeding amount,improve the compliance rate of early enteral nutrition;third Decoction engenders pill improve feeding intolerance symptoms from descending order is bladder pressure>>diarrhea and vomiting,Decoction in engenders pill and improve constipation patients showed no advantage;the Zisheng pill decoction can improve early enteral nutrition in patients with severe nutritional status and immune index. |
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