基于人工智能肠鸣音监测探究“卯时气注大肠”的临床意义  

Clinical Significance of“Qi Going into Large Intestine Meridian at Maoshi”Based on Artificial Intelligence Monitoring Technology of Bowel Sounds

作　　者：沈丹丽 章程 成汇[1,2] 潘华峰 龚冠闻 王刚[1] 刘江 江志伟 SHEN Danli;ZHANG Cheng;CHENG Hui;PAN Huafeng;GONG Guanwen;WANG Gang;LIU Jiang;JIANG Zhiwei(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学,江苏南京210023

出　　处：《辽宁中医杂志》2021年第4期13-16,I0001,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81704083);江苏省中医药管理局重点项目(ZD201903);江苏省科技计划重点病种规范化诊疗项目(BE2015687);江苏省研究生科研创新计划项目(SJCX20-0603)。

摘　　要：目的基于人工智能肠鸣音(bowel sounds,BS)监测技术观测卯时BS的变化,探究“卯时气注大肠”对患者术后康复的影响。方法选取2019年1月—2019年12月于江苏省中医院行腹腔镜下胃癌根治术的30例患者(男21例,女9例),进行术前1天和术后第1天的BS监测。分析术前十二时辰平均肠率(bowl rate,BR)的变化趋势,并根据术后第1天卯时BS的恢复情况,将患者分为两组,分析术后第1天卯时BS的恢复情况对手术患者预后的影响。结果十二时辰的平均BR总体上呈现出白天升高,夜间低平的趋势;卯时是白天BR升高的起始点。相对于术后卯时BR恢复不良者,术后卯时BR的正常恢复是术后转归的保护因素,能够降低并发症的发生率(OR=0.06,95%IC 0.00~0.92)。术后卯时BS低下或亢进都会延长患者术后首次通气时间(P=0.03)、术后首次通便时间(P=0.02)和住院时间(P=0.01),加剧了机体的炎症反应(P<0.01)。结论人体BS存在昼夜节律,卯时是一个关键点。术后“卯时气注大肠”,患者才能如期康复。Objective This research is based on the artificial intelligence bowel sounds monitoring detection technology to observe the changes of bowel sound in Maoshi(the period of the day from 5 a.m.to 7 a.m.),and explore the influence of“Qi going into large intestine meridian at Maoshi”on the postoperative rehabilitation of patients.Methods From January 2019 to December 2019,30 patients(21 males and 9 females)who underwent laparoscopic gastrectomy in Jiangsu Hospital of Traditional Chinese Medicine were selected to be monitored their bowel sounds the day before and after operation.According to the recovery of bowel sounds on the first day after operation,the patients were divided into two groups.The recovery of bowel sounds on the first day after operation was analyzed.Results On the whole,the average 24 h bowl rate showed a trend of rising in the daytime and reducing at night.Maoshi was the starting point of the increase of bowl rate during the day.Compared with the patients with poor recovery of bowl rate at Maoshi after operation,the recovery of bowl rate at Maoshi after operation was the protective factor of postoperative outcome,which can reduce the incidence of complications(OR=0.06,95%CI 0.00-0.92).Because of the hypofunction or hyperfunction of the bowel sounds in the postoperative period,the first ventilation time(P=0.03),the first defecation time(P=0.02)and the hospitalization time(P=0.01)were prolonged,and the inflammatory response of the body was intensified(P<0.01).Conclusion There are circadian rhythms in human bowel sounds,and Maoshi is a key point.Only when Qi goes into the intestine at Maoshi postoperatively can the patients recover regularly.

关 键 词：子午流注 肠鸣音 肠率 大肠经 昼夜节律 人工智能 

分 类 号：R224.3[医药卫生—中医基础理论]