The auxiliary effect of decoction of four-drug juice combined with glutamine on nutritional support in the elderly critical ill patients

Abstract

Objective To explore the effect of decoction of four-drug juice plus glutamine on nutritional support in the elderly critically ill patients. Methods One hundred and twenty-four elderly critical ill patients in The First Hospital of Jilin University from May 2010 to May 2012 were randomly divided into treatment group（n= 62）and control group（n = 62）. Patients in both two groups were given enteral nutrition（EN）plus parenteral nutrition（PN）after the hemodynamics became stable. In addition,patients in control group were given routine EN ＋ PN,while in treatment group was given decoction o four-drug juice ＋ EN plus glutamine ＋ PN. Prealbumin （PA）,serum total protein（ TP）,transferrin（ TF）and serum albumin（ ALB）were detected before and after treatment of nutritional support. The informations including recovery of bowel sounds,the occurrence of complications,antibiotic use time and the duration of ICU stay were recorded. Results There were no significant differences between two groups in terms of nutrition indices before treatment（P 〉 0. 05）. After treatment,the contents of pre albumin,transferrin,total serum protein,serum albumin in treatment group were（ 145. 24 ± 6. 72）g/ L,（1. 93 ± 0. 98）g/ L,（79. 86 ± 10. 38）g/ L,（54. 91 ± 2. 91）g/ L respectively,better than those in control groups（（139. 24 ± 38. 76）,（1. 68 ± 0. 33）,（74. 73 ± 7. 31）,（49. 87 ± 2. 61）g/ L）,and the differences were statistically significant（ t = 3. 610,2. 929,4. 360,6. 767;P 〈 0. 05）. The incidence of stress ulcer and double infection in treatment group were 42%（26 / 62）,37%（23 / 62）,significantly lower than the control group（59%（37 / 62）,53%（33 / 62））,and the differences were statistically significant（ χ2 = 5. 186, 5. 271,P 〈 0. 05）. Antibiotic use time and the duration of ICU stay in treatment group were（8. 82 ± 0. 71）d and（16. 14 ± 3. 01）d,and reaching full eternal nutrition time was（6. 90 ± 1. 01）d,decreased less than that in control group（（10. 21 ± 1. 30）,（20. 67 ± 2. 29）,（13. 91 ± 1. 51）d）and the differences were statistically significant（t = 8. 892,7. 786,3. 609,P 〈 0. 05）. The average recovery time of bowel sounds and first anal exhaust time average in treatment group were（26. 8 ± 3. 6）h,（25. 4 ± 3. 2）h,lower than that in control group （（38. 4 ± 4. 8）h,（37. 6 ± 4. 9）h）and the differences were statistically significant（ t = 3. 551,2. 516,P〈 0. 05）. Conclusion The application of decoction of four-drug juice plus glutamine on nutritional support of the elderly critically ill patients can reduce complications,shorten the duration of ICU,recover the intestinal function as soon as possible. Meanwhile,patients can transit to full eternal nutrition as soon as possible,then the cost of therapy is reduced and rehabilitation is quickly. Key words: Critically ill; Nutritional support; Decoction of four-drug juice; Glutamine; Elderly