【摘要】 目的：观察温肾健脾汤联合蒙脱石散对重症监护病房（ICU）脾肾阳虚型腹泻患者的治疗疗效。方法：选取ICU脾肾阳虚型腹泻患者63例，按随机数字表法分为观察组32例和对照组31例。对照组采用蒙脱石散治疗，观察组在对照组基础上联合温肾健脾汤治疗。比较2组临床疗效、止泻时间以及肠内营养足量时间、胃肠动力学指标[血清胃泌素（GAS）、胃动素（MOT）、5-羟色胺（5-HT）]、C-反应蛋白（CRP）、红细胞沉降率（ESR）水平、并发症及不良反应发生情况。结果：观察组总有效率为96.88%，对照组为74.19%，组间比较，差异有统计学意义（P<0.05）。治疗后，2组血清GAS、MOT、5-HT水平均较治疗前下降（P<0.05），且观察组GAS、MOT、5-HT水平均低于对照组（P<0.05）。治疗后，2组CRP、ERS水平均较治疗前降低（P<0.05），且观察组CRP、ERS水平均低于对照组（P<0.05）。治疗后，观察组止泻时间、肠内营养足量时间均短于对照组，差异有统计学意义（P<0.05）。观察组无出现不良反应，对照组不良反应发生率为9.68%,2组比较，差异无统计学意义（P>0.05）。2组均未见严重并发症。结论：温肾健脾汤联合蒙脱石散治疗ICU脾肾阳虚型腹泻疗效显著，可促进胃肠道功能恢复，缓解机体炎症反应，且无明显不良反应。更多还原

【Abstract】 Objective: To observe the clinical effects of Wenshen Jianpi Decoction combined with Montmorillonite Powder for patients with diarrhea of spleen-kidney yang deficiency type in intensive care unit(ICU). Methods:A total of 63 cases of patients with diarrhea of spleen-kidney yang deficiency type in ICU were selected and divided into the observation group(32 cases) and the control group(31 cases)according to the random number table method. The control group was treated with Montmorillonite Powder,and the observation group was additionally treated with Wenshen Jianpi Decoction based on the treatment of the control group. Clinical effects, the time of diarrhea to be treated, the time of enteral nutrition to be sufficient, the levels of serum gastrointestinal motility indexes [gastrin(GAS), motilin(MOT),and 5-hydroxytryptamine(5-HT)],C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR),and the incidence of adverse reactions and complications were compared between the two groups.Results:The total effective rate was 96.88% in the observation group and 74.19% in the control group,and the comparison between the two groups showed significance in the difference(P<0.05). After treatment, the levels of GAS, MOT, and 5-HT in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the three levels in the observation group were lower than those in the control group(P<0.05). After treatment,the levels of CRP and ERS in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of CRP and ERS in the observation group were lower than those in the control group(P<0.05). After treatment,the time of diarrhea to be treated and the time of enteral nutrition to be sufficient in the observation group were shorter than those in the control group,the difference being significant(P<0.05). There were no adverse reactions happened in the observation group,and the incidence of adverse reactions in the control group was 9.68%in the control group,no significant difference being found in the comparison between the two groups(P>0.05). No serious complications occurred in the two groups. Conclusion: Wenshen Jianpi Decoction combined with Montmorillonite Powder has a significant curative effect in the treatment of diarrhea of spleen-kidney yang deficiency type in ICU, which can promote the recovery of gastrointestinal function and relieve inflammatory reactions without any obvious adverse reaction.更多还原