理气化湿法联合针刺治疗呼吸机依赖患者胃肠功能障碍的临床研究  

Clinical Study on Combination of Resolving Damp and Regulating Qi and Acupuncture in Treatment of Gastrointestinal Dysfunction of Patients with Ventilator Dependence

作　　者：董妍 李岩涛[1] 于盼盼[2] 施保柱 杨明华 刘源 许梅 DONG Yan;LI Yantao;YU Panpan;SHI Baozhu;YANG Minghua;LIU Yuan;XU Mei(Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China;Hebei Medical University,Shijiazhuang 050017,Hebei,China)

机构地区：[1]河北省中医院,河北石家庄050011 [2]河北医科大学,河北石家庄050017

出　　处：《中华中医药学刊》2021年第7期221-224,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划(2019048,2019042)。

摘　　要：目的评价理气化湿法联合针刺治疗对呼吸机依赖患者胃肠功能障碍的作用。方法采用随机对照研究,将2018年1月—2020年1月符合呼吸机依赖肠功能障碍的医院重症监护病房(ICU)患者,随机分为治疗组和对照组各25例。对照组采用呼吸支持、控制感染、保护胃肠黏膜、胃肠动力药物、灌肠等常规西医治疗,治疗组在对照组治疗基础上加用三仁汤联合针刺治疗。比较两组治疗前后胃肠功能障碍评分、中医证候积分评分、胃残留量、腹腔压力、胃窦运动指数、大便量、氧合指数变化。结果治疗后,治疗组中医证候积分有效率高于对照组(P=0.016),具有统计学意义;治疗组较对照组胃肠功能障碍评分降低(P=0.011),具有统计学意义;治疗后第3天、第7天,两组胃残留量减少、腹腔压力降低、胃窦运动指数增加、大便量增加、氧合指数均较前改善(均P<0.05),且治疗组优于对照组(P<0.05),差异具有统计学意义。结论理气化湿法联合针刺治疗可以改善呼吸机依赖胃肠功能障碍患者中医证候积分、胃肠功能障碍评分,减少胃残留量、降低腹腔压力、增加胃窦运动指数、增加大便量、提高氧合指数,从而改善改善呼吸机依赖患者胃肠功能和呼吸功能。Objective To evaluate the effect of the combination of resolving damp and regulating Qi with acupuncture on gastrointestinal dysfunction of ventilator dependent patients. Methods A randomized controlled study was used to randomly divide the ICU patients from January 2018 to January 2020 who met the requirements into the treatment group and the control group. The control group was treated with western medicine, such as respiratory support, infection control, gastrointestinal mucosa protection, gastrointestinal motility drugs, enema and so on. The treatment group was treated with Sanren Decoction(三仁汤) combined with acupuncture on the basis of the treatment in the control group. Before and after treatment, gastrointestinal dysfunction score, TCM syndrome score, gastric retention, abdominal pressure, motilite index, fecal weight, oxygen and indexes were compared between the two groups. Result After treatment, the effective rate of TCM syndrome score in the treatment group was higher than that in the control group(P=0.016), which was statistically different. The gastrointestinal dysfunction score in the treatment group was lower than that in the control group(P=0.011), which was statistically different. On the third and seventh day after treatment, the gastric retention, abdominal pressure, motilite index, fecal weight, oxygen and indexes in the two groups were all improved(P<0.05), and the treatment group’s were better than those of the control group(P<0.05), which were statistically different. Conclusion The combination of resolving damp and regulating Qi method and acupuncture can improve the TCM syndrome score and gastrointestinal dysfunction score of gastrointestinal dysfunction of patients with ventilator dependent, reduce gastric retention volume and abdominal pressure, increase motilite index, fecal weight and oxygen and indexes, so as to improve the gastrointestinal function and respiratory function of patients with ventilator dependent.

关 键 词：呼吸机依赖 胃肠功能障碍 理气化湿 针刺 

分 类 号：R245.31[医药卫生—针灸推拿学] R259.744[医药卫生—中医临床基础]