Study On Prevention Of ICU Acquired Weakness In Patients With Mechanical Ventilation By Early Integrated Traditional Chinese And Western Medicine

Objective: To evaluate the effects of early integrated traditional Chinese and western medicine strategies on muscle strength,ICUAW incidence,activity of daily life,mechanical ventilation time,length of stay in the ICU and total length of stay.Methods: By using the method of randomized controlled trial study from January 2019 to December 2019 in Xinjiang Urumqi city A third rate into exclusion standard of 156 cases of hospital ICU mechanical ventilation patients were randomly divided into 4 groups: control group(group A: conventional rehabilitation nursing),Chinese medicine rehabilitation intervention group(group B1: conventional rehabilitation nursing +traditional Chinese medicine therapy),western medicine physical rehabilitation intervention group(group B2: conventional rehabilitation nursing +western medicine physical rehabilitation),intervention group which combines traditional Chinese medicine with western medicine(B3 groups: conventional rehabilitation nursing +traditional Chinese medicine therapy +western medicine physical rehabilitation).After the implementation of early rehabilitation,the patient's limb strength(MRC-Score),basic life activity ability Score(Barthel Index Score),mechanical ventilation time,ICU hospitalization time and total hospitalization time were measured.The collected data were statistically analyzed using SPSS 22.0.Results: 1.Comparison of general clinical baseline data(age,gender,main clinical diagnosis,Barthel Index score and APACHE II score in the two weeks before admission)of patients in the four groups showed no statistically significant difference(P > 0.05),and the groups were comparable.2.Effect on the incidence of ICUAW: the incidence of ICUAW in the four groups was 45.71%,35.90%,20.51%,and 14.29% in group A,group B1,group B2,and group B3,respectively,with statistically significant differences(P < 0.05).3.The MRC-Score of the four groups of patients was: group A(43.94±12.58),group B1(48.51±3.59),group B2(48.72±4.63),and group B3(53.23±5.94).Pairwise comparison showed that,except for group B1 and group B2,there were differences in comparison among other groups when transferred out of ICU(P < 0.05).3.Comparison of Barthel Index,Barthel Index scores of the four groups of patients after intervention were: group A(66.14±19.25),group B1(72.69±12.61),group B2(72.95±10.68),and group B3(79.57±7.80),respectively,with statistically significant differences between the four groups(P < 0.05).4.Effects on mechanical ventilation time of patients in the four groups: group A(254.06±126.22)h,group B1(188.41±80.44)h,group B2(172.90±68.74)h,and group B3(162.06±76.27)h.The difference of mechanical ventilation time between group A and group B1,B2 and B3 was statistically significant(P < 0.05).5.The effect on length of stay and total length of stay in ICU was statistically significant between group A and group B2 and group A and group B3(P < 0.05).Compared with group B3,only the length of stay in ICU was statistically significant(P < 0.05).Conclusion: 1.Traditional Chinese medicine therapy intervention group,western medicine rehabilitation intervention group and integrated Chinese and western medicine intervention group are all significant for improving the muscle strength of patients with mechanical ventilation in the ICU.2.Compared with traditional Chinese medicine therapy and western medicine rehabilitation intervention alone,integrated Chinese and western medicine intervention strategy is more effective in improving or maintaining limb strength in ICU patients with mechanical ventilation.3.Western medicine rehabilitation intervention and integrated Chinese and western medicine rehabilitation intervention can reduce the incidence of ICUAW.4.Traditional Chinese medicine therapy intervention group,western medicine rehabilitation intervention group and integrated Chinese and western medicine intervention group are all effective in enhancing the daily activities of patients with mechanical ventilation in the ICU.5.Compared with the use of traditional Chinese medicine therapy and western medicine rehabilitation intervention alone,the intervention strategy of integrated Chinese and western medicine is more effective in enhancing the daily activities of ICU patients with mechanical ventilation.6.Early integrated Traditional Chinese medicine therapy and western medicine intervention strategy can reduce mechanical ventilation time,ICU hospitalization time and total hospitalization time of ICU patients with mechanical ventilation.