摘要
危重症病情紧急,常因重度感染、创伤等引起胃肠功能障碍,不利继续治疗。胃气学说与现代营养支持学说摄入、吸收、转化利用等环节上具有统一性。有胃气则生,无胃气则死,此百病之大纲也。危重症患者,顾护胃气可转化为营养支持。早期顾护胃气,在胃气理论指导下,合理营养支持,保护胃肠黏膜、维持机体内稳态平衡,有利于营养物质吸收,为危重症治疗提供必要保障,加快疾病恢复。早期营养支持不仅是为了改善营养状态,更重要是保护机体肠道黏膜屏障功能,维持机体内稳态平衡,有利于加速康复。肠内营养常见不良反应包括胃潴留、反流腹胀、腹泻等并发症,常以健脾疏肝、化湿和胃、调理气机为主要治则。针刺可增加胃动力,促进胃排空,改善胃潴留,效果优于胃动力药。中药治疗虚则补之,香砂六君子汤能明显降低胃潴留及反流腹胀;实则泄之,大承气汤峻下热结,可调节肠道菌群,保护肠道屏障,改善胃潴留。通过胃气理论指导、探讨营养支持在危重症治疗中的重要意义,发挥中医药优势,弥补现代医学的不足,为中西医结合治疗危重症提供基础。
Critically ill is emergency, attributed to gastrointestinal dysfunction, which often caused by severe infection,trauma and etc, adverse to continue treatment. The relationship between stomach Qi theory and modern nutrition support theory is of unity on the link of intake, absorption and transformation using. Have stomach qi is live, otherwise to be dead, which is the outline of the disease. Protecting stomach qi can be converted into nutritional support for Critically ill patients. Under the guidance of the stomach Qi theory, protecting stomach Qi early, through reasonable nutrition support, which protecting gastrointestinal mucousmembrane and maintaining the body＇s homeostasis balance,provides the necessary guarantee for critically ill treatment and promotes recovery of disease. Early nutrition support is not only to improve nutritional status,more important is to protect the intestinal mucosal barrier function, maintain the body＇s homeostasis balance, which beneficial to accelerate recovery. Enteral nutrition common adverse reactions including complications such as gastric retention,reflux abdominal distension, diarrhea, often by invigorating spleen and soothing liver, removing dampness to regulate stomach, regulating Qi as the main therapeutic principle. Acupuncture can increase the stomach power, promote the gastric emptying, improve gastric retention,its effect is better than the gastric motility drug. The treatment of Chinese medicine： by treating deficiency with tonification, Xiangsha Liujunzi decoction can obviously decrease gastric retention and reflux abdominal distension; by treating excess with purgation, Dachengqi decoction can modulate intestinal flora, protect the intestinal mucosal barrier function and promote the gastric emptying. Discussing the important value of nutrition support in critically ill treatment, through the guidance of the stomach Qi theory, it takes Chinese medicine advantage, supplements modern medical and provides the basis for critically ill treatment by combination traditional Chinese and western medicine.
出处
《实用中医内科杂志》
2016年第6期56-58,共3页
Journal of Practical Traditional Chinese Internal Medicine
关键词
危重症
早期顾护胃气
营养支持
肠道黏膜屏障
虚则补之
香砂六君子汤
胃潴留
反流腹胀
实则泻之
大承气汤
峻下热结
肠道菌群
改善预后
critically ill patients
early protecting stomach Qi
nutritional support
intestinal mucosal barrier
virtual filling
Xiangsha Liujunzi decoction
gastric retention
reflux in relief
abdominal distension
Dachengqi decoction
hot Jun under the intestinal microflora
prognosis
