针刺治疗老年重症肺炎合并胃肠功能障碍的临床观察  

Effects of acupuncture on elderly patients with severe pneumonia combined with gastrointestinal dysfunction

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

机构地区：[1]浙江医院,杭州310013

出　　处：《中华中医药杂志》2016年第4期1520-1522,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药管理局项目(No.2010ZA002);浙江省重点科技创新团队计划(No.2011R50018)~~

摘　　要：目的:评价针刺治疗对老年重症肺炎患者胃肠功能的作用。方法:将64例重症肺炎患者随机分为对照组(31例)和针刺组(33例),观察其临床症状、胃肠激素、胃残留量(GRV)、腹腔内压力(IAP)和急性生理与慢性健康Ⅱ(APACHEⅡ)评分。结果:针刺组返流呕吐消失时间和肠鸣间恢复正常时间较对照组明显改善(P<0.05);与治疗前比较,针刺组治疗后GRV、APACHEⅡ评分下降(P<0.01),MOT增高,GAS和D-乳酸水平均显著降低(P<0.05,P<0.01);与对照组同期比较,针刺组IAP、APACHEⅡ评分、MOT、GAS、D-乳酸改善显著(P<0.05,P<0.01);总有效率明显高于对照组(P<0.05)。结论:针刺治疗能够有效地改善老年重症肺炎患者的胃肠道症状,减少胃储留及腹腔内压力水平,其改善胃肠功能机制可能与通过调节胃肠激素水平、改善胃肠屏障功能有关。Objective： To evaluate the effects of acupuncture on gastrointestinal function in elderly patients with severe pneumonia. Methods： Sixty-four patients with severe pneumonia were randomly divided into control group（31 cases） and acupuncture group（33 cases）. The clinical symptoms, gastrointestinal hormone levels, gastric residual volume（GRV）, intraabdominal pressure（IAP） and APACHE Ⅱ score were observed. Results： The reflux disappear time and gurgling sound resume time in acupuncture group were significantly better than that of control group after treatment（P〈0.05）. After treating, GRV and APACHE Ⅱ score decreased（P〈0.01）, the levels of serum MOT increased, GAS and D-lactate reduced（P〈0.05, P〈0.01）. Compared with the control group, IAP, APACHEⅡscore, MOT, GAS and D-lactate in acupuncture group were improved（P〈0.05, P〈0.01）, the total effective rate in acupuncture group was increased（P〈0.05）. Conclusion： Acupuncture could effectively improve the gastrointestinal symptoms, reduce GRV and IPA in elderly patients with severe pneumonia, and the mechanism of improving gastrointestinal function might be relate with its effects in regulating gastrointestinal hormone levels and improving gastrointestinal mucosal barrier function.

关 键 词：重症肺炎 胃肠功能 针刺 胃肠激素 胃动素 胃泌素 D-乳酸 老年 

分 类 号：R246.1[医药卫生—针灸推拿学]