2025 年第 1 期 第 20 卷

温脾除胀汤治疗脾阳虚型胃肠功能障碍的临床效果

The clinical effect of Wenpi Chuzhang decoction in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type

作者：王雷1 张静2 金友刚3 谷楠4 李宝瑞5 魏娜6  施保柱6  耿艳娜1

英文作者：Wang Lei1 Zhang Jing2 Jin Yougang3 Gu Nan4 Li Baorui5 Wei Na6 Shi Baozhu6 Geng Yanna1

单位：1河北省中医院重症医学科，石家庄050013；2河北省中医院泌尿外科，石家庄050013；3河北省唐山市迁西县人民医院综合内科，唐山064303；4河北省优抚医院综合内科，石家庄050062；5河北省沧州市盐山阜德医院综合内科，沧州061399；6河北省中医院呼吸重症科，石家庄050013

英文单位：1Department of Critical Care Medicine Hebei Provincial Hospital of Traditional Chinese Medicine Shijiazhuang 050013 China; 2Department of Urology Hebei Provincial Hospital of Traditional Chinese Medicine Shijiazhuang 050013 China; 3Department of General Internal Medicine Qianxi County People′s Hospital Hebei Province Tangshan 064303 China; 4Department of General Internal Medicine Hebei Provincial Youfu Hospital Shijiazhuang 050062 China; 5Department of General Internal Medicine Yanshan Fude Hospital Hebei Province Cangzhou 061399 China; 6Department of Respiratory Critical Care Hebei Provincial Hospital of Traditional Chinese Medicine Shijiazhuang 050013 China

关键词：胃肠功能障碍；  温脾除胀汤；  脾阳虚型；  急性生理学与慢性健康状况评分系统Ⅱ评分

英文关键词：Gastrointestinaldysfunction;  WenpiChuzhangdecoction;  SpleenYangdeficiencytype;  AcutephysiologyandchronichealthevaluationⅡscore

• 摘要：

• 目的  探讨温脾除胀汤治疗脾阳虚型胃肠功能障碍的临床效果。方法  按随机数字表法将2021年1月至2022年9月在河北省中医院重症监护病房住院的脾阳虚型胃肠功能障碍患者50例分入观察组和对照组，各25例。对照组给予西医常规治疗，观察组在对照组的基础上予以温脾除胀汤治疗，2组均连续治疗7 d。比较2组治疗前后的临床疗效、急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分、中医证候积分、胃肠功能相关指标和炎症因子水平及不良反应发生情况。结果  观察组总有效率明显高于对照组［96.0%（24/25）比72.0%（18/25）］（P＜0.05）。治疗后2组患者APACHE Ⅱ评分、中医证候积分均低于治疗前，且观察组均低于对照组（均P＜0.05）。治疗后2组胃肠功能障碍评分、腹内压、腹围、平均胃潴留量均低于/小于治疗前，且观察组上述指标均低于/小于对照组（均P＜0.05）。治疗后2组患者白细胞计数、肿瘤坏死因子α、降钙素原水平均低于治疗前，且观察组各炎症因子水平均低于对照组（均P＜0.05）。治疗期间，2组患者均未出现不良反应，同时患者血常规、尿常规、便常规指标均保持正常。结论  温脾除胀汤治疗脾阳虚型胃肠功能障碍患者效果确切，能改善患者胃肠功能，抑制炎症因子。

• Objective  To investigate the clinical effect of Wenpi Chuzhang decoction in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type. Methods   According to the random number table method, 50 patients with gastrointestinal dysfunction of spleen Yang deficiency type who were hospitalized in the Department of Critical Care Medicine, Hebei Provincial Hospital of Traditional Chinese Medicine from January 2021 to September 2022 were divided into observation group and control group, with 25 cases in each group. The control group was treated with conventional western medicine, and the observation group was treated with Wenpi Chuzhang decoction on the basis of the control group. Both groups were treated for 7 d. The clinical efficacy, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, traditional Chinese medicine (TCM) syndrome score, gastrointestinal function related indicators, inflammatory factor levels and adverse reactions were compared between the two groups before and after treatment. Results   The total effective rate of the observation group was significantly higher than that of the control group ［96.0%(24/25) vs 72.0%(18/25)］(P＜0.05). After treatment, the APACHE Ⅱ score and TCM syndrome score of the two groups were lower than those before treatment, and those of the observation group were lower than those of the control group (all P＜0.05). After treatment, the gastrointestinal dysfunction score, intra-abdominal pressure, abdominal circumference, and average gastric retention in the two groups were lower/less than those before treatment, and the above indexes in the observation group were lower/less than those in the control group (all P＜0.05). After treatment, the white blood cell count, tumor necrosis factor-α, and procalcitonin levels of the two groups were lower than those before treatment, and the levels of inflammatory factors in the observation group were lower than those in the control group (all P＜0.05). During the treatment period, there were no adverse reactions in the two groups, and the routine indexes of blood, urine, and stool remained normal.Conclusion   Wenpi Chuzhang decoction is effective in the treatment of gastrointestinal dysfunction of spleen Yang deficiency type, which can improve gastrointestinal function and inhibit inflammatory factors.