中国中西医结合杂志2025，Vol.45Issue(7)：819-826,8.DOI:10.7661/j.cjim.20250508.043
广义估计方程评价针刺对脓毒症急性肌萎缩患者股直肌肌肉容积的影响
Effect of Acupuncture on Rectus Femoris Cross-sectional Area in Patients with Sepsis-induced Myopathy Based on the Generalized Estimating Equation
摘要
Abstract
Objective To assess the impact of acupuncture on the cross-sectional area of the rectus femoris(RFCSA)in patients with sepsis-induced myopathy(SIM).Methods A retrospective design was performed,and all 37 patients met the diagnosis and inclusion criteria of SIM from January 2018 to December 2021.The RFCSA of all enrolled patients on the third day of ICU admission decreased by more than 9.24％in comparison to the first day of ICU admission.Patients were labeled to the acupuncture group(7 cases)if they received acupuncture treatment between days 3 and 6;those who did not were in the control group(30 cases).Data on the RFCSA values of patients were collected from the day of ICU admission until their discharge from the ICU.The RFCSA value recorded on the third day of ICU admission served as the baseline measurement.The RFCSA values taken on the 6th,9th,12th,and 15th days of ICU stay were considered the primary outcomes.We utilized the generalized estimating equation(GEE)model to compare RFCSA from day 3 to day 15.Secondary outcomes included the duration of invasive mechanical ventilation,ICU length of stay,and in-hospital stay.Results GEE analysis indicated no significant difference in the estimated marginal means of RFCSA(baseline)on day 3 between groups(P=0.547).An interaction effect was noted between time and group(Wald x2=23.276,P＜0.001).Time point effect:The difference in mean RFCSAfor the control group decreased over time.Group effect:On day 3,the mean RFCSA of the acupuncture group was lower than that of the control group(P=0.547),whereas,by day 6,it had exceeded that of the control group,although the difference was not significant(P=0.162).By days 9,12,and 15 of the ICU stay,the mean RFCSA values in the acupuncture group were higher than those in the control group,and the mean difference gradually increased(P=0.044,0.045,0.005).Conclusion Acupuncture may mitigate the loss of rectus femoris muscle volume and should be considered a therapeutic option during the initial stages of an ICU stay.关键词
脓毒症/脓毒症急性肌萎缩/股直肌横截面积/针刺/广义估计方程Key words
sepsis/sepsis-induced myopathy/rectus femoris cross-sectional area/acupuncture/generalized estimating equation引用本文复制引用
陈伟焘,林新锋,杨忠奇,刘南,田宁,江其龙,李淑贤,叶楚桥,李春河,陈静,刘燕燕,李军,俞秋云,宁怡乐..广义估计方程评价针刺对脓毒症急性肌萎缩患者股直肌肌肉容积的影响[J].中国中西医结合杂志,2025,45(7):819-826,8.基金项目
广东省自然科学基金面上项目(No.2019A1515011010) （No.2019A1515011010）
广东省中医药局科研项目(No.20192018,No.20211126) （No.20192018,No.20211126）
