合募配穴治疗危重症患者肠内营养喂养不耐受的疗效观察OACSTPCD
Effect of the combination of he-sea and front-mu points on enteral nutrition feeding intolerance in critical illness patients
目的:观察合募配穴对危重症肠内营养喂养不耐受(ENFI)患者喂养达标率、腹内压、肠内营养耐受性评分、急性生理学和慢性健康状况评价Ⅱ(APACHE-Ⅱ)评分和胃肠功能损伤(AGI)等级的影响,评价合募配穴治疗ENFI的临床疗效.方法:将70例ENFI患者随机分为对照组、治疗组各35例.对照组采用常规基础治疗联合肠内营养支持;治疗组在对照组治疗基础上取上脘、中脘、下脘、气海、关元及双侧内关、足三里、下巨虚、上巨虚、天枢、大横针刺,其中天枢、大横左右各为一组,分别接电针仪的一对电极,每次30 min,每日1次,连续7 d.观察两组患者治疗期间每日喂养达标人数,计算喂养达标率,记录治疗期间肠内营养耐受性评分、腹内压、APACHE-Ⅱ评分和AGI等级.结果:治疗后两组肠内喂养达标率较治疗前升高,且治疗组除第2天以外肠内喂养达标率均高于对照组(P<0.05);治疗后两组肠内营养耐受性评分、腹内压、APACHE-Ⅱ评分和AGI等级均较治疗前降低(P<0.05,P<0.01),且治疗组低于对照组(P<0.05).结论:合募配穴可以通过增加ENFI患者肠内营养喂养量,改善ENFI情况,提高患者喂养水平,促进胃肠功能恢复,有利于患者预后.
Objective To explore the effects of the combination of he-sea and front-mu points on the feeding compliance rate,the intra-abdominal pressure,the enteral nutrition tolerance score,the score of acute physiological and chronic health evaluation(APACHE)-Ⅱ and gastrointestinal function impairment grade in the patients with enteral nutrition feeding intolerance(ENFI)of critical illness and evaluate clinical effect on ENFI after acupuncture at the he-sea and front-mu points.Methods Seventy patients of ENFI were randomized into a control group and an observation group,35 cases in each one.In the control group,the patients were treated with routine regimen combined with intesti-nal nutrition support.In the observation group,on the basis of the treatment as the control group,acupuncture was ap-plied to Shangwan(CV13),Zhongwan(CV12),Xiawan(CV10),Qihai(CV6)and Guanyuan(CV4),as well as bila-teral Neiguan(PC6),Zusanli(ST36),Xiajuxu(ST39),Shangjuxu(ST37),Tianshu(ST25)and Daheng(SP15).Of those acupoints,ST25 and SP15 on the same side were attached to one pair of electrodes(20 Hz/100 Hz).Acupunc-ture was delivered once daily,30 min each time and for consecutive 7 days.During treatment,the numbers of the cases up to the feeding standard were observed everyday to calculate the feeding compliance rate.The score of enteral nutrition tolerance,the intra-abdominal pressure,the score of APACHE-Ⅱ and the level of acute gastriointestinal injury(AGI)grading were recorded.Results After treatment,the enteral feeding compliance rate was increased in compari-son with that before treatment in the two groups,and the rate in the observation group was higher than that of the con-trol group(P<0.05)except that on the 2nd day.The score of the enteral nutrition tolerance,the intra-abdominal pres-sure,the score of APACHE-Ⅱ and the level of AGI were all reduced(P<0.05,P<0.01)when compared with those be-fore treatment in the two groups,and these indicators in the observation group were lower(P<0.05)than those of the control group.Conclusion Acupuncture at the he-sea and front-mu points relieves the conditions of ENFI,improves the feeding and the recovery of gastrointestinal function,and benefits the prognosis through increasing the amount of enteral nutrition in ENFI patients.
陈晓桐;李璟;王文佳;吴梦蝶;钱义明;谢静;侯瑜超;李俊雄
上海中医药大学附属岳阳中西医结合医院,上海 200437
合募配穴危重症患者肠内喂养不耐受胃肠功能
Combination of he-sea and front-mu pointsPatients of critical illnessEnteral feeding intoleranceGastrointestinal function
《针刺研究》 2024 (001)
64-70 / 7
上海市中医诊疗模式创新试点建设项目(No.ZY[2018-2020]-FWTX-6012);上海市进一步加快中医药传承创新发展三年行动计划项目(No.ZY[2021-2023]-0302);上海市临床重点专科(针灸)建设项目(No.shslczdzk04701);上海市名老中医学术经验研究工作室建设项目(No.SHGZS-202212).
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