应用电针干预重症早期急性胰腺炎并发肠麻痹  

Efficacy observation of electroacupuncture intervention on severe acute pancreatitis at early stage complicated with intestinal paralysis

作　　者：罗艳红[1] 钟广伟[2] 赵双平[3] 唐红梅[2] 张丽娜[3] 

机构地区：[1]中南大学湘雅医院急诊科,湖南长沙410008 [2]中南大学湘雅医院中西医结合研究所,湖南长沙410008 [3]中南大学湘雅医院ICU病室,湖南长沙410008

出　　处：《中国针灸》2011年第2期105-109,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:探讨早期应用电针干预重症急性胰腺炎(SAP)并发肠麻痹的临床疗效。方法:68例SAP患者随机分为观察组(48例)和对照组(20例),观察组根据病程分为早期组(3天内入院治疗)30例和晚期组(3～7天内入院治疗)18例。对照组予常规治疗,观察组在常规治疗基础上加电针中脘、足三里、内关、合谷等穴。比较各组治疗后急性病生理学和长期健康评估Ⅱ(APACHEⅡ)评分、肠麻痹及实验室指标恢复正常时间、并发症、中转手术率、死亡率及住院时间的情况。结果:早期组总有效率为83.3%(25/30),优于晚期组的72.2%(13/18)和对照组的65.0%(13/20)(P<0.05,P<0.01);早期组腹痛缓解时间、腹胀缓解时间、肠鸣音恢复正常时间、排气恢复时间、排便恢复时间均显著短于晚期组和对照组(P<0.05,P<0.01),早期组APACHEⅡ评分、白细胞及血尿淀粉酶恢复正常时间、并发症、中转手术率、死亡率及住院时间均明显低于晚期组和对照组(P<0.05,P<0.01),但晚期组与对照组比较,两者差异无统计学意义(均P>0.05)。结论:电针干预SAP患者并发肠麻痹的临床疗效明显优于常规治疗,同时早期应用电针干预优于晚期干预的疗效。Objective To explore the clinical efficacy of electroacupuncture intervention on severe acute pancreati tis （SAP） at early stage complicated with intestinal paralysis. Methods Sixty-eight cases of SAP were randomly divided into observation group （48 cases） and control group （20 cases）. In observation group, according to the course of sickness, the early-stage subgroup （30 cases, hospitalized in 3 d） and late stage subgroup （18 cases, hospitalized in 3-7 d） were subdivided. In control group, the conventional treatment was applied. In observation group, based on the same treatment as control group, electroacupuncture was supplemented at Zhongwan （CV 12）, Zusanli （ST 36）, Neiguan （PC 6）, Hegu （LI 4）, etc. Acute physiology and chronic health evaluation （APACHE） II scores, the recovery time of intestinal paralysis and laboratory indices, complications, operation transfer rate, death rate and the admission time were compared among groups after treatment. Results The total effective rate was 83.3% （25/30） in early-stage subgroup, which was superior to 72.2% （13/18） in late-stage subgroup and 65.0% （13/20） in control group （P〈0.05, P〈0.01）. In early-stage subgroup, the remission time of abdominal pain, the remission time of abdominal distention, the recovery time of borborygums, the recovery time of gas discharge, and the recovery time of defecation were all shorter significantly than those in late-stage subgroup and control group （P〈0.05,P-〈0.01）. In early-stage subgroup, APACHE II scores, the recovery time of WBC and blood/uric amylase, complications, operation transfer rate, death rate and admission time were all lower remarkably than those in late-stage subgroup and control group （P〈0.05 ,P〈0.01） ; but, there were no statistical significant differences in comparison between late-stage subgroup and control group （all P〉0. 05）. Conclusion The clinical efficacy of electroacupuncture intervention on SAP complicated with intestinal paralysis

关 键 词：重症急性胰腺炎 肠麻痹 电针 

分 类 号：R246.2[医药卫生—针灸推拿学]