电针治疗对危重病患者胃肠功能的影响  

Effect of Electroacupuncture on Gastrointestinal Function in Critically ⅢPatients

作　　者：祁相焕[1] 王绍谦[1] 张德恩[1] 张冬惠[1] 

机构地区：[1]开封市第二人民医院,开封475002

出　　处：《上海针灸杂志》2015年第10期917-920,共4页Shanghai Journal of Acupuncture and Moxibustion

基　　金：开封市科学技术发展基金项目(1403079)

摘　　要：目的观察早期针刺干预对危重病患者胃肠功能的影响。方法将112例危重病患者随机分为两组,常规组在治疗原发病的基础上,加用生大黄、枯草杆菌二联活菌肠溶胶囊(美常安),必须肠外营养时加用丙氨酰谷氨酰胺注射液;针刺组在常规组治疗方法的基础上加用电针治疗,每日1次。在治疗前及治疗7 d、14 d,对两组患者进行胃肠功能评分、营养状况(血红蛋白、白蛋白)、营养方式、APACHEⅡ评分、胃肠功能衰竭发生率、死亡率比较。结果治疗7 d,两组胃肠功能评分均较治疗前改善(P<0.05),针刺组与常规组比较差异有统计学意义(P<0.05);治疗14 d后,两组胃肠功能评分与同组治疗前比较差异有统计学意义(P<0.01),针刺组与常规组比较差异有统计学意义(P<0.05)。治疗7 d、14 d,两组APACHEII评分均较治疗前改善(P<0.01),治疗7 d时,针刺组与常规组比较差异有统计学意义(P<0.05);治疗14 d时,针刺组与常规组比较差异有统计学意义(P<0.05)。治疗7 d,两组患者血红蛋白与治疗前比较差异无统计学意义(P>0.05),两组之间比较差异无统计学意义(P>0.05);治疗14 d,两组患者血红蛋白与治疗前比较差异有统计学意义(P<0.05),两组之间比较差异有统计学意义(P<0.05)。治疗7 d,两组患者白蛋白与治疗前比较差异无统计学意义(P>0.05),两组之间比较差异无统计学意义(P>0.05);治疗14 d时,两组患者白蛋白与治疗前比较差异有统计学意义(P<0.05),两组之间比较差异有统计学意义(P<0.05)。针刺组死亡10例,常规组死亡13例,两组患者死亡率比较差异无统计学意义(P>0.05),但针刺组死亡率低于常规组;针刺组有3例完全肠外营养转变为混合营养,常规组最终有4例不能耐受肠内营养,转换为混合营养,2例转换为完全肠外营养。结论两组治疗均能有效改善患者胃肠功能,降低胃肠功能衰竭发生率,针刺组效果优于常规组;两组治疗均能有�Objective To observe the effect of early-stage intervention with acupuncture on gastrointestinal dysfunction in critically ill patients. Method Totally 112 critically ill patients were randomized into two groups. Based on the treatment for primary disease, the conventional group additionally received Lived Combined B. Subtilis and E. Faecium Enteric-coated Capsules, plus Alanyl Glutamine injection when parenteral alimentation was required; in addition to the treatments given to the conventional group, the acupuncture group received electroacupuncture, once a day. Before treatment, and on treatment day 7 and day 14, the gastrointestinal function and nutritional state（hemoglobin, albumin）, nutrition type, APACHE Ⅱ score, incidence rate of gastrointestinal function failure, and mortality rate were evaluated and compared. Result After 7-day treatment, the gastrointestinal function scores were significantly improved in both groups（P0.05）, and there was a significant difference between the acupuncture group and conventional group（P0.05）; after 14-day treatment, the gastrointestinal function scores were significantly improved in both groups compared to that before treatment（P0.01）, and there was a significant difference between the acupuncture group and conventional group（P0.05）. Respectively after 7-day and 14-day treatment, the APACHE Ⅱ scores were significantly improved in both groups（P0.01）, and there was a significant difference between the acupuncture group and conventional group（P0.05）; after 14-day treatment, there was a significant difference between the two groups（P0.05）. After 7-day treatment, the hemoglobin levels were insignificantly changed in the two groups（P0.05）, and the difference was insignificant between the two groups（P0.05）; after 14-day treatment, the hemoglobin levels were significantly changed in both groups compared to that before treatment（P0.05）, and there was a significant difference between the two groups（P0.05）. After 7-day treatment, the

关 键 词：危重病 电针 胃肠功能障碍 营养状况 预后 多器官功能障碍综合征 

分 类 号：R246.1[医药卫生—针灸推拿学]