电针联合早期益生菌治疗神经重症继发急性胃肠损伤的疗效观察  

Efficacy Observation of Electro-acupuncture Stimulation of Acupoint Therapy Combined with Early Probiotics in the Treatment of Neurosevere Patients with Acute Gastrointestinal Injury

作　　者：王成鑫 陈锋 廖加抱 陈凤娟 Wang Chengxin;Chen Feng;Liao Jiabao;Chen Fengjuan(Jiaxing Hospital of TCM,Zhejiang,Jiaxing 314001,China)

机构地区：[1]浙江省嘉兴市中医院,浙江嘉兴314001

出　　处：《中国中医急症》2022年第11期1986-1990,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：嘉兴市医学重点学科建设项目[2019XK-F01-ICU(2021)]。

摘　　要：目的 探讨神经重症合并急性胃肠损伤(AGI)患者采用电针刺激穴位联合早期益生菌治疗的效果。方法 将98例神经重症合并AGI患者随机均分为两组,对照组49例给予早期益生菌治疗,观察组49例给予早期益生菌+电针刺激穴位疗法,疗程7 d。统计临床疗效,记录患者治疗前后的急性生理与慢性健康Ⅱ(APACHEⅡ)评分、胃肠功能衰竭(GIF)评分、肠鸣音次数、血清中的D-乳酸、二胺氧化酶(DAO)水平。记录患者机械通气时间、ICU住院时间、首次排便时间、院内获得性肺炎(HAP)发生率及28 d病死率。结果 观察组与对照组的治疗总有效率(91.84%vs 77.55%)比较有显著差异(P<0.05);观察组治疗后的APACHEⅡ评分、GIF评分、机械通气时间、ICU住院时间以及首次通便时间均较对照组显著减少(P<0.05),肠鸣音次数显著高于对照组(P<0.05);观察组治疗后血清中的D-乳酸和DAO含量与对照组相当(P>0.05);两组的HAP发生率(6.12%vs 10.20%)与28 d病死率(14.29%vs 18.37%)相当(P>0.05)。结论 在早期益生菌用药基础上加以电针刺激穴位疗法治疗神经重症合并AGI疗效确切,可显著改善胃肠道功能,促进患者的早期康复。Objective:To explore the effect of electro-acupuncture stimulation acupoint therapy combined with early probiotic treatment in patients with severe neurological disease complicated with acute gastrointestinal injury(AGI). Methods:A total of 98 patients with severe neurological disease combined with AGI were randomly divided into two groups. 49 patients in the control group were treated with early probiotics,and 49 patients in the observation group were treated with early probiotics+electro-acupuncture acupoint stimulation therapy. The course of treatment was 7 days. The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),gastrointestinal failure(GIF),number of bowel sounds,D-lactic acid and diamine oxidase(DAO)in serum were recorded before and after treatment. The duration of mechanical ventilation,intensive care unit(ICU)stay,time of first bowel movement,incidence of hospital-acquired pneumonia(HAP)and 28 day mortality of the two groups were recorded and compared. Results:There was a significant difference in the total effective rate of treatment between the observation group and the control group(91.84% vs 77.55%)(P< 0.05). After treatment,the APACHEⅡ score,GIF,mechanical ventilation time,ICU stay and time of first bowel movement in the observation group were significantly decreased compared with the control group(P< 0.05). The number of bowel sounds increased significantly compared with the control group(P< 0.05). The expression levels of D-lactic acid and DAO in the serum of the observation group after treatment were similar to those of the control group(P >0.05). The incidence of HAP(6.12% vs10.20%)in the two groups was comparable to the 28-day mortality rate(14.29% vs 18.37%)(P >0.05). Conclusion:On the basis of early probiotics medication,electro-acupuncture stimulation acupoint therapy is effective in the treatment of severe neurological disease complicated with AGI,which can significantly improve the gastrointestinal function of patients and promote the early recovery of patients.

关 键 词：神经重症 急性胃肠损伤 电针 益生菌 疗效 

分 类 号：R741[医药卫生—神经病学与精神病学]