叶圣 魏春晖 陈强

摘要：目的 觀察四磨汤口服液治疗近足月儿喂养不耐受的临床疗效及安全性，探讨肠系膜上动脉血流时间平均流速（TAMV）增幅对该病的价值。方法 采用抽签法将85例患儿随机分为对照组41例和观察组44例。2组均进行综合治疗及喂养调控，连续治疗7 d。观察组在此基础上予四磨汤口服液，每次1 mL/kg，每日3次，口服或鼻饲，连续治疗2 d。比较2组治疗后无胃潴留、呕吐停止、全肠内营养和住院时间，观察2组治疗前后中医症状积分、TAMV增幅，评价临床疗效，监测安全性指标。结果 观察组治疗后达到无胃潴留、呕吐停止、全肠内营养和住院时间短于对照组（P<0.05）。与本组治疗前比较，2组治疗后中医症状积分下降（P<0.05）；2组治疗后比较，观察组中医症状积分低于对照组（P<0.05）。观察组总有效率为86.36%（38/44），对照组为68.29%（28/41），观察组明显优于对照组（P<0.05）。与本组治疗前比较，2组治疗后TAMV增幅提高（P<0.05）；2组治疗后比较，观察组TAMV增幅高于对照组（P<0.05）。2组均未发生不良反应。结论 四磨汤口服液治疗近足月儿喂养不耐受可改善症状、缩短住院时间，疗效显著，无明显不良反应。通过监测TAMV增幅可对该病进行预判和监测。

关键词：四磨汤口服液；近足月儿；喂养不耐受

DOI：10.3969/j.issn.1005-5304.2018.11.007

中图分类号：R272.957 文献标识码：A 文章编号：1005-5304（2018）11-0027-04

Abstract： Objective To study the clinical efficacy and safety of Simo Decoction for the treatment of feeding intolerance of near term infants； To explore the value of increase of time averaged mean velocity （TAMV） in the superior mesenteric artery. Methods Totally 85 patients were randomly divided into control group （41 cases） and observation group （44 cases）. Both two group were given comprehensive treatment and feeding regulation， lasted for 7 d. The observation group was given Simo Decoction on the basis of the control group， 1 mL/kg each time， 3 times a day， orally or nasal feeding， lasted for 2 days. After the treatment， no gastric retention time， vomiting ceased time， total enteral nutrition time， and hospitalization time were compared， and the total TCM syndrome scores and TAMV increase were observed. Clinical efficacy was evaluated and safety indexes were monitored. Results No gastric retention time， vomiting ceased time， total enteral nutrition time and hospitalization time in the observation group were shorter than the control group （P<0.05）. Compared with before treatment， the total TCM syndrome scores in the two groups decreased after treatment （P<0.05）； After treatment， the total TCM syndrome scores in the observation group were lower than those in the control group （P<0.05）. The total effective rate was 86.36% （38/44） in the observation group and 68.29% （28/41） in the control group. The observation group was significantly better than the control group （P<0.05）； After treatment， the TAMV increase in the observation group was higher than that in the control group （P<0.05）. No adverse reactions occurred in both groups. Conclusion Simo Decoction can improve the symptoms and shorten the time of hospitalization in the treatment of feeding intolerance of near term infants， with confirmed efficacy and no obvious adverse reactions， which can be prejudged and monitored by monitoring TAMV increase.

Keywords： Simo Decoction； near term infants； feeding intolerance

临床上，早产儿以孕周34周为界分为早期早产儿（孕周达28周但不足34周）和晚期早产儿（孕周达34周但不足37周），后者又被称为近足月儿。有报道显示，近足月儿占早产儿的72%[1]。近足月儿消化系统发育不健全，加之住院时存在的各种疾病状态，导致发生喂养不耐受（feeding intolerance，FI）。国内报道显示，近足月儿FI发生率为30.2%～56.6%[2]。由于FI干扰肠内营养的建立，造成近足月儿发育障碍，延长住院时间，甚至危及生命。有研究者应用四磨汤口服液治疗早产儿FI疗效显著[3-4]，但针对近足月儿FI的相关研究仍较少。本研究观察四磨汤口服液治疗近足月儿FI的临床疗效和安全性，现报道如下。

1 资料与方法

1.1 一般资料

收集2016年3月-2018年3月本院新生儿科85例近足月儿FI，采用抽签法随机分为对照组41例和观察组44例。……