电针联合清胰汤辅助治疗重症急性胰腺炎相关肺损伤的回顾性研究  

A retrospective study of electroacupuncture combined with Qingyi decoction as an adjuvant treatment for severe acute pancreatitis-associated lung injury

作　　者：赵丁欢 杜越 杜诗涵 李翠[1] 胡欣欣 谢子雷 张圆[1] 余剑波[1] Zhao Dinghuan;Du Yue;Du Shihan;Li Cui;Hu Xinxin;Xie Zilei;Zhang Yuan;Yu Jianbo(Department of Anesthesiology and Critical Care Medicine,Tianjin Medical University Nankai Clinical College,Tianjin 300100,China)

机构地区：[1]天津医科大学南开临床学院,天津市南开医院麻醉科和重症医学科,300100

出　　处：《中华麻醉学杂志》2021年第4期469-473,共5页Chinese Journal of Anesthesiology

摘　　要：回顾性收集2016年1月1日至2020年12月31日本院重症医学科收治的重症急性胰腺炎患者的临床资料,根据其是否接受电针联合清胰汤治疗分为电针联合清胰汤治疗组(针药组)和常规组,采用治疗倾向性评分预测模型进行配对筛选,每组122例。电针选取穴位:足三里、三阴交、合谷、上巨虚、下巨虚及太冲穴等,均采用手法运针得气后进行电针治疗,1或2次/d。清胰汤胃注和(或)灌肠治疗,2~4剂/d。主要结局指标为急性呼吸窘迫综合征(ARDS)发生率,次要结局指标为并发症发生情况及出院结局。与常规组比较,针药组ARDS发生率降低,机械通气时间缩短,肾功能异常发生率、急性生理学与慢性健康状况评分系统评分、序贯性器官衰竭评分、床旁急性胰腺炎严重度评分降低,外科干预比率升高,总住院时间延长,住院期间病死率降低(P<0.05)。亚组分析结果显示,发病时间(<1周)、合并心血管疾、糖尿病、胆源性胰腺炎和酒精性胰腺炎病史、高热、穿刺引流是电针联合清胰汤治疗的重症急性胰腺炎患者发生ARDS的影响因素。综上所述,电针联合清胰汤辅助治疗重症急性胰腺炎,可减轻急性肺损伤,促进患者恢复,降低病死率。The clinical data of patients with severe acute pancreatitis admitted to the Department of Intensive Care Unit in our hospital from January 1,2016 to December 31,2020 were retrospectively collected.The patients were divided into electroacupuncture combined with Qingyi decoction treatment group(acupuncture group)and conventional group according to whether the patients received electroacupuncture combined with Qingyi decoction treatment.A prediction model of treatment propensity score was established for paired screening,with 122 cases in each group.The acupoints such as Zusanli,Sanyinjiao,Hegu,Shangjuxu,Xiajuxu,and Taichong were selected,and then electroacupuncture treatment was performed after qi arrival using the manipulation technique,1 or 2 times per day.Qingyi decoction was injected through the stomach and/or Qingyi decoction was given by coloclysis,2-4 doses per day.The main outcome was the incidence of acute respiratory distress syndrome(ARDS),and the secondary outcome was the occurrence of complications and outcome of discharge.Compared with conventional group,the incidence of ARDS was significantly decreased,the time of mechanical ventilation was shortened,the incidence of renal dysfunction,score for acute physiology and chronic health score system,sequential organ failure score,and score for the severity of bedside acute pancreatitis were decreased,the rate of surgical intervention was increased,the total length of hospital stay was prolonged,and the fatality rate during hospitalization was reduced in acupuncture group(P<0.05).The results of subgroup analysis showed that the onset time of disease(<1 week),a history of cardiovascular disease,diabetes mellitus,biliary pancreatitis and alcoholic pancreatitis,high fever,puncture and drainage were influencing factors for ARDS developed in the patients who received electroacupuncture combined with Qingyi decoction for treating severe acute pancreatitis.In conclusion,electroacupuncture combined with Qingyi decoction as an adjuvant treatment for severe acute pan

关 键 词：胰腺炎 肺损伤 电针 中草药 

分 类 号：R246.1[医药卫生—针灸推拿学]