| Objective:To evaluate the effect of Shenling Baizhu Powder on the prognosis of critically ill patients with enteral nutrition,and to observe its efficacy and safety.Method:A randomized,double-blind,multi-center parallel control study was conducted to select 220 ICU patients who met the inclusion criteria from June 2017 to December 2018 in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Yanjiang District Hospital of Ziyang City,Xindu District Hospital of Traditional Chinese Medicine,and Suining Hospital of Traditional Chinese Medicine.Patients who met the inclusion criteria were randomly divided into two groups.The conventional enteral nutrition was supplemented with Shenling Baizhu Powder as group A(treatment group),and conventional enteral nutrition was added with placebo as group B(control group).The course of treatment is completed until the end of the ICU.The general conditions of the two groups(including gender,age,pre-ICU infection and mechanical ventilation before enrollment),new infection rate after ICU admission,ventilator time,ICU length of stay,APACHE II Score before and after treatment,changes in hemoglobin,albumin,prealbumin,gastrointestinal nutrition intolerance and mortality rate were recorded in the two groups.Statistical analysis was performed using SPSS22.0.It was observed whether there were statistical differences between the two groups.P<0.05 was statistically significant.Result:Among the 220 subjects,112 were in the treatment group(72 males,40 females,mean age 63.81±13.78 years),and 108 patients in the control group(66 males and 42 females,with an average age of 65.00±13.11 years).The results were as follows:(1)There was no significant difference between the treatment group and the control group in terms of gender,age,pre-ICU infection and mechanical ventilation before enrollment(P>0.05);(2)incidence of new infection after ICU treatment group 26.8%,the control group was 30.6%,there was no statistically significant difference between the groups(P>0.05);(3)Comparison of physical and chemical indicators before and after treatment: hemoglobin(g/L): treatment group: before treatment(110.91)±26.90)vs after treatment(112.65±25.75);control group: before treatment(114.60±28.65)vs after treatment(108.43±22.12),P>0.05;prealbumin(mg/L): treatment group: before treatment(142.31±75.6)vs treatment(161.35±49.34);control group: before treatment(137.18±67.64)vs treatment(138.41±68.71),P<0.05;albumin(g/L): treatment group: before treatment(34.36±5.67)vs after treatment(35.12±3.95);control group: treatment Before treatment(34.88±5.25)vs after treatment(33.57±4.26),P<0.05.(4)The ventilator time of the treatment group(136.67±183.67 hours)was less than that of the control group(193.16±227.23 hours),the difference was statistically significant(P<0.05);(5)the hospitalization time of the treatment group(13.07±11.98 days)was less than There was no significant difference between the two groups(14.75±11.35 days)(P>0.05).(6)APACHE II scores decreased after treatment,but the treatment group decreased more significantly.The difference was statistically significant [APACHE II Scoring: treatment group: before treatment(19.95±3.54)vs treatment(15.21±4.73);control group: before treatment(20.25±3.26)vs treatment(16.74±5.15),P<0.05].(7)Different degrees of gastrointestinal nutritional intolerance occurred in both groups,16.1% in the treatment group and 27.8% in the control group,the difference was statistically significant(P<0.05);(8)Comparison of mortality between the two groups: death in the treatment group The rate was 8%,and the mortality of the control group was 9.3%.There was no significant difference between the two groups(P>0.05).Conclusion:The addition of Shenling Baizhu Powder to enteral nutrition of critically ill patients has significant clinical effects on improving the tolerance of enteral nutrition,improving nutritional status of patients,shortening mechanical ventilation time and improving patient prognosis.However,there was no significant improvement in the incidence of new infections,hospitalization time and mortality of critically ill patients after entering ICU. |
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