电针足三里穴防治老年机械通气患者胃食管反流  

Effect of Electroacupuncture at Zusanli(ST36)on Prevention of Gastroesophageal Reflux in Mechanically Ventilated Elderly Patients

作　　者：雷澍[1] 江荣林[1] 夏国莲[1] 黄立权[1] 徐勇刚[1] 

机构地区：[1]浙江中医药大学附属第一医院,浙江杭州310006

出　　处：《中华中医药学刊》2012年第8期1756-1759,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技项目(2008CB007)

摘　　要：目的:观察电针足三里穴防治老年机械通气患者胃食管反流及呼吸机相关肺炎(ventilator associatedpneumonia,VAP)的疗效。方法:ICU内82例机械通气的老年患者纳入本研究,随机分为治疗组(41例)和对照组(41例)。对照组采取常规防治胃食管反流措施,治疗组在对照组治疗方案基础上予电针足三里穴治疗。观察治疗前后两组咽后部液体胃蛋白酶阳性率变化和VAP发生率,测定两组患者治疗前后血胃动素、胃泌素水平。结果:与治疗前比较,治疗组和对照组治疗后咽后部液体胃蛋白酶阳性率均有所下降(P<0.05),但治疗组治疗后咽后部液体胃蛋白酶阳性率低于对照组(P<0.05),治疗组VAP发生率低于对照组(P<0.05)。治疗组治疗后胃动素水平有所升高(P<0.05),胃泌素水平无明显变化(P>0.05)。对照组治疗前后胃动素和胃泌素水平均无明显变化(P>0.05)。结论:电针足三里穴能有效改善胃肠功能,减少胃食管反流,减少呼吸机相关肺炎的发生,其机制可能与提高血胃动素水平有关。Objective ： To observe the effect of Electroacupuncture （EA） at Zusanli （ST36） on prevention of gastroesoph- ageal reflux and ventilator associated pneumonia（ VAP） in mechanically ventilated elderly patients. Methods：A total of 82 mechanically ventilated elderly patients were included in the study and were randomly divided into treatment group （n = 41 ） and the control group（ n = 41 ）. Patients in control group were treated with conventional measures to prevent gastroe- sophageal reflux on the basis of conventional therapy. Patients in the treatment group were treated with EA at Zusanli （ST36） on the basis of measures to prevent gastroesophageal reflux in control group. The positive rate of pepsin in fluid of back pharynx,motilin（MTL） and gastrin（GAS） levels in blood before and after treatment and incidence of VAP were ob- served. Results：Compared with that before treatment, the positive rate of pepsin in fluid of back pharynx in both treatment group and control gToup decreased significantly（ P 〈 0.05 ）. But alter treatment the positive rate of pepsin in fluid of back pharynx in treatment group was lower than that in control group（ P 〈 0.05 ）. The incidence of VAP in the treatment group was significantly lower than that in the control group （P 〈 0.05 ）. Compared with that before treatment, the MTL levels in treatment group increased significantly after treatment（ P 〈 0.05 ） , but GAS levels did not change significantly before and after treatment（ P 〉 0.05 ）. There were no significant changes in MTL and GAS before and after treatment in the control group （ P 〉 0.05 ）. Conclusion ： EA at Zusanli （ ST36 ） can improve gastrointestinal function, reduce gastroesophageal reflux and the incidence of VAP,which may be related to increasing the level MTL in blood.

关 键 词：电针 足三里穴 胃食管反流 呼吸机相关肺炎 胃动素 

分 类 号：R245.97[医药卫生—针灸推拿学]