本文選題：調(diào)脾益腎法 + 營養(yǎng)不良�。� 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：觀察調(diào)脾益腎法聯(lián)合腸內(nèi)營養(yǎng)治療脾腎虧虛型老年股骨頸骨折患者術(shù)后營養(yǎng)不良的臨床療效。方法：將48例脾腎虧虛型老年股骨頸骨折術(shù)后營養(yǎng)不良患者隨機(jī)分為中藥組24例,對照組24例,于患者術(shù)前及術(shù)后1周進(jìn)行量表打分,營養(yǎng)狀況測評以及血液指標(biāo)檢驗(yàn),并予以藥物干預(yù),其中中藥組予以調(diào)脾益腎方湯劑日二次水煎服,同時予以腸內(nèi)營養(yǎng)方案,對照組僅予以腸內(nèi)營養(yǎng),治療三周后再次進(jìn)行量表打分,營養(yǎng)狀況測評及血液指標(biāo)檢驗(yàn),對比三次數(shù)據(jù),討論結(jié)論。結(jié)果： (1)證候積分對比：兩組術(shù)前積分與治療前積分對比,差異無統(tǒng)計(jì)學(xué)意義(p0.05)；治療前積分對比,差異無統(tǒng)計(jì)學(xué)意義(p0.05),中藥組治療前后對比,差異有統(tǒng)計(jì)學(xué)意義(p0.05),對照組治療前后對比,差異無統(tǒng)計(jì)學(xué)意義(p0.05);兩組療后積分對比差異有統(tǒng)計(jì)學(xué)意義(p0.05)；(2)營養(yǎng)風(fēng)險(xiǎn)篩查：兩組患者術(shù)前積分、治療前積分對比,差異無統(tǒng)計(jì)學(xué)意義(t=0.59,p0.05),中藥組治療后與治療前相比差異有統(tǒng)計(jì)學(xué)意義(p0.05)；對照組治療后治療前相比差異有統(tǒng)計(jì)學(xué)意義(p0.05),中藥組與對照組治療后對比差異有統(tǒng)計(jì)學(xué)意義(p0.05)(3)SGA評分等級：兩組患者術(shù)前積分、治療前積分對比,差異無統(tǒng)計(jì)學(xué)意義(p0.05),中藥組治療后與治療前相比差異有統(tǒng)計(jì)學(xué)意義(p0.05)；對照組治療后治療前相比差異有統(tǒng)計(jì)學(xué)意義(p0.05),中藥組與對照組治療后對比差異有統(tǒng)計(jì)學(xué)意義(p0.05)(4)血液指標(biāo)：兩組患者術(shù)前、治療前血液指標(biāo)(血紅蛋白、白蛋白、前白蛋白)對比,差異無統(tǒng)計(jì)學(xué)意義(p0.05),中藥組治療后與治療前相比差異均有統(tǒng)計(jì)學(xué)意義(p0.05)；對照組在血紅蛋白、白蛋白方面治療后治療前相比差異有統(tǒng)計(jì)學(xué)意義(p0.05),前白蛋白方面治療前后對比差異無統(tǒng)計(jì)學(xué)意義(p0.05)中藥組與對照組治療后血液指標(biāo)對比差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論：1、股骨頸骨折術(shù)后患者在術(shù)后一周所有會出現(xiàn)不同程度的營養(yǎng)不良狀況,這可能與術(shù)中出血、手術(shù)應(yīng)激以及術(shù)后活動減少,飲食吸收差等有關(guān)。2、調(diào)脾益腎法聯(lián)合腸內(nèi)營養(yǎng)與單純腸內(nèi)營養(yǎng)均能改善脾腎虧虛型老年股骨頸骨折術(shù)后營養(yǎng)不良狀況。3、調(diào)脾益腎法具有益氣健脾、強(qiáng)筋補(bǔ)腎等功效,聯(lián)合腸內(nèi)營養(yǎng)對脾腎虧虛型老年股骨頸骨折術(shù)后營養(yǎng)不良的效果優(yōu)于單純應(yīng)用腸內(nèi)營養(yǎng)。
[Abstract]:Objective: to observe the clinical effect of regulating spleen and tonifying kidney combined with enteral nutrition in treating postoperative malnutrition in elderly patients with deficiency of spleen and kidney. Methods: 48 cases of senile femoral neck fracture with deficiency of spleen and kidney were randomly divided into Chinese medicine group (n = 24) and control group (n = 24). The traditional Chinese medicine group was given decoction of Tiaopi Yishen decoction twice a day and enteral nutrition program was given, while the control group was given enteral nutrition only. After three weeks of treatment, the Chinese medicine group was scored again with the scale. Nutritional status evaluation and blood index test were compared with three times of data, and the conclusion was discussed. Results: comparison of syndrome score: there was no significant difference between preoperative integral and pre-treatment score in the two groups, but there was no significant difference in the score before treatment (P 0.05), while in the traditional Chinese medicine group, the difference was not statistically significant before and after treatment, and there was no significant difference between the two groups before and after treatment. The difference was statistically significant (P 0.05). There was no significant difference before and after treatment in the control group (P 0.05). There was a significant difference between the two groups (P < 0.05). The nutritional risk screening: the scores before operation and before treatment were compared between the two groups. There was no statistical difference between the two groups. There was a significant difference between the Chinese medicine group and the control group after treatment, and there was a significant difference before and after treatment in the control group, and there was a significant difference between the Chinese medicine group and the control group after treatment. SGA score grade: two groups of patients before operation integral, Score comparison before treatment, There was no significant difference between Chinese medicine group and control group after treatment, there was significant difference before and after treatment in Chinese medicine group, and there was significant difference before treatment in control group, and there was significant difference between Chinese medicine group and control group after treatment. Blood index: two groups of patients before operation, There was no significant difference in blood indexes (hemoglobin, albumin, prealbumin) before treatment. Before and after treatment, there was no significant difference in blood indexes between the Chinese medicine group and the control group (P 0.05, P 0.05), and there was no significant difference before and after treatment in the traditional Chinese medicine group and the control group (P < 0.05), and there was no significant difference between the Chinese medicine group and the control group before and after treatment. Conclusion 1: all patients with femoral neck fracture have different degrees of malnutrition at the first week after operation, which may be associated with intraoperative bleeding, surgical stress and decreased postoperative activity. The method of regulating spleen and tonifying kidney combined with enteral nutrition and simple enteral nutrition can improve the malnutrition status of senile patients with deficiency of spleen and kidney after operation of femoral neck fracture. The method of regulating spleen and tonifying kidney has the effects of tonifying qi and invigorating spleen, strengthening the tendon and tonifying the kidney, and so on. Combined enteral nutrition was superior to enteral nutrition in the treatment of malnutrition after operation for senile femoral neck fracture with deficiency of spleen and kidney.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9

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