针灸对老年重症肺炎患者胃肠功能及胃肠激素的影响  

Effects of Acupuncture on Gastrointestinal Function and Gastrointestinal Hormone in Elderly Patients with Severe Pneumonia

作　　者：虞意华[1] 金肖青[2] 俞迈红[2] 龚仕金[1] 汪燕[1] 刘秉宇[1] 严静[1] 

机构地区：[1]浙江医院重症医学科,杭州310013 [2]浙江医院针灸科,杭州310013

出　　处：《浙江中西医结合杂志》2015年第10期901-904,共4页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：浙江省中医药科技计划项目(No.2010ZA002);重症医学科技创新团队项目(No.2011R50018)

摘　　要：目的评价针灸对老年重症肺炎患者胃肠功能恢复及胃肠激素的调节作用及其可能机制。方法选择本院重症医学科(ICU)收治的重症肺炎患者64例,按随机数字表法分为对照组(31例)和针灸组(33例),两组均给予抗感染常规治疗,针灸组在常规治疗基础上行针灸,1天1次,疗程5天。于治疗前、治疗后3天、7天观察两组患者临床症状、血清胃动素(MOT)、胃泌素(GAS)水平、胃残留量(GRV)、腹腔内压力(IAP)和急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,并进行胃肠功能障碍疗效评价。结果针灸组患者临床胃肠道症状较对照组明显改善(P<0.05);两组血清MOT水平增高,GAS水平下降,胃残余量明显减少,腹腔内压力、APACHEⅡ评分均明显降低,针灸组上述指标改善明显优于对照组,以治疗后7天变化更显著[MOT:(378.40±130.55)pg/m L比(306.51±121.36)pg/m L;GAS:(70.23±33.16)pg/m L比(110.98±47.43)pg/m L;GRV:(79.70±70.02)m L比(118.06±114.96)m L;IAP:(9.36±4.34)mm Hg比(12.39±5.77)mm Hg;APACHEⅡ评分:(16.88±4.71)分比(19.61±4.53)分;P<0.05或P<0.01)。胃肠功能障碍疗效评分显效率(36.4%比19.4%,P<0.05);总有效率(63.6%比38.7%,P<0.05)均高于对照组。结论针灸能有效改善老年重症肺炎患者的胃肠道症状,显著减少胃储留及腹腔内压力,增加血清MOT,降低GAS,降低APACHEⅡ评分,显著提高疗效。Objective To investigate the regulation of gastrointestinal function by acupuncture in elderly patients with severe pneumonia and the possible underlying mechanism. Methods Sixty-four patients with severe pneumoni-a in our Intensive Care Unit（ICU） were selected, and they were randomly divided into control group（n=31 cases） and acupuncture group（n=33 cases）. Conventional treatment was given to both groups, and acupuncture was addi-tionally applied in acupuncture group once a day for 5d. Before the treatment and 3d and 7d after treatment, the changes of clinical symptoms, gastrointestinal hormone level（MOT and GAS）, gastric residual volume（GRV）, intra-abdominal pressure（IAP）, acute physiology and chronic health evaluation II（APACHE II） score were observed, and the therapeutic effect of gastrointestinal dysfunction was evaluated in both groups. Results The improvement of clinical symptoms of acupuncture group was significantly better than that of control group（P〈0.05）. After treat-ment, the serum MOT levels increased and GAS levels, GRV, IAP, APACHE IIscores reduced in both groups;significant differences were noted on day 7 after treatment between acupuncture group and control group（MOT：378.40±130.55pg/L vs 306.51±121.36pg/L; GAS：70.23±33.16pg/L vs 110.98±47.43pg/L; GRV：79.70±70.02mL vs 118.06±114.96mL; IAP：9.36±4.34mmHg vs 12.39±5.77mmHg; APACHEIIscore：16.88±4.71 vs 19.61±4.53; P〈0.05 or P〈0.01）. The gastrointestinal dysfunction score showed significantly different marked effectiveness and total effec-tiveness between acupuncture group and control group（36.4% vs 19.4%; 63.6% vs 38.7%; both P〈0.05）. Conclu-sion Acupuncture can effectively improve gastrointestinal function in elderly patients with severe pneumonia by reducing GRV, IAP and APACHEIIscore, increasing serum MOT and decreasing GAS.

关 键 词：重症肺炎 老年 胃肠功能 针灸 胃肠激素 胃动素 胃泌素 

分 类 号：R246.1[医药卫生—针灸推拿学]