针刺联合大柴胡汤对急性重症脑卒中患者肠道功能保护的临床研究  

Clinical Study of Acupuncture Combined with Dachaihu Decoction on Intestinal Function Protection in Patients with Acute Severe Stroke

作　　者：黄壑霏 彭晓洪[1] 黄亚秀 陈冬杰 王评[1] HUANG He-fei;PENG Xiao-hong;HUANG Ya-xiu;CHEN Dong-jie;WANG Ping(Shenzhen Hospital of Beijing University of Traditional Chinese Medicine,Guangdong Shenzhen 518172)

机构地区：[1]北京中医药大学深圳医院,广东深圳518172

出　　处：《深圳中西医结合杂志》2021年第6期12-15,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：深圳市科创委计划项目资助课题(JCYJ20180302150228829)。

摘　　要：目的:观察针刺联合大柴胡汤加减对急性期脑卒中患者肠道屏障功能的改善作用。方法:选取北京中医药大学深圳医院2018年6月至2020年10月期间收治的80例急性重症脑卒中患者,随机分为对照组与观察组,各40例。两组予相同基础治疗,对照组配合枸橼酸莫沙必利片、双歧杆菌三联活性胶囊治疗,观察组则加用针刺联合大柴胡汤加减治疗。两组患者疗程均为7 d。记录两组患者的28 d死亡率、住院时间;比较急性生理及慢性健康评分Ⅱ(APACHEⅡ)、脏器功能不全评分(MODS)、胃肠功能障碍评分、血清脂多糖(LPS)、D-乳酸(D-LA)水平变化。结果:观察组28 d死亡率7.5%,对照组为20.0%,差异无统计学意义(P>0.05);观察组住院时间(15.56±6.75)d短于对照组住院时间(19.73±7.59)d,差异具有统计学意义(P<0.05);治疗前两组患者的APACHEⅡ、MODS评分、胃肠功能积分比较,差异无统计学意义(P>0.05)。治疗后两组患者的APACHEⅡ、MODS评分、胃肠功能积分均有不同程度下降,且观察组低于对照组,差异具有统计学意义(P<0.05);治疗前两组患者的LPS、D-LA水平比较,差异无统计学意义(P>0.05)。治疗后两组患者的LPS、D-LA水平均有不同程度下降,且观察组患者低于对照组,差异具有统计学意义(P<0.05)。结论:针刺联合大柴胡汤加减能改善急性重症脑卒中患者肠黏膜屏障功能,缩短住院时间。Objective To observe the improvement effect of acupuncture combined with Dachaihu Decoction on intestinal barrier function in patients with acute stroke.Methods From June 2018 to October 2020,80 patients with acute severe stroke in Shenzhen hospital of Beijing University of traditional Chinese medicine were randomly divided into two groups,40 cases each.The control group was treated with mosapride citrate tablets and Bifidobacterium triple active capsules,while the treatment group was treated with acupuncture combined with Dachaihu decoction.Both groups were treated for 7 days.The 28 day mortality and hospital stay were recorded,and the changes of acute physiology and chronic health score(APACHEⅡ),Multiple organ dysfunction score(MODS),gastrointestinal dysfunction score,serum endotoxin(LPS)and D-lactic acid(d-la)levels were compared between the two groups.Results On the 28th day,3 people died in the observation group and 8 people died in the control group,the difference was not statistically significant(P>0.05);The length of stay in the observation group was(15.56±6.75)days shorter than that in the control group(19.73±7.59)days,and the difference was statistically significant(P<0.05);Before treatment,there was no statistically significant difference in APACHEⅡ,MODS scores,and gastrointestinal function scores between the two groups of patients(P>0.05).After treatment,the APACHEⅡ,MODS scores,and gastrointestinal function scores of the two groups of patients decreasedto varying degrees,and the decline in the observation group was greater than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of LPS and D-LA between the two groups of patients(P>0.05).After treatment,the LPS and D-LA levels of the two groups of patients decreased to varying degrees,and the decrease of the observation group was greater than that of the control group,the difference was statistically significant(P<0.05).Conclusion Acu

关 键 词：急性重症脑卒中 针刺 大柴胡汤 

分 类 号：R743.3[医药卫生—神经病学与精神病学]