不同电针方案对术后肠麻痹的临床疗效及胃肠激素水平影响的正交试验  

Orthogonal Experimental Design of Different Electroacupuncture Schemes on the Clinical Efficacy of Postoperative Intestinal paralysis and the Effects of Gastrointestinal Hormone Levels

作　　者：李群 杨先玉[2] 陈盼敏 郑慧华[2] 喻敏 Li Qun;Yang Xianyu;Chen Panmin;Zheng Huihua;Ya Min(Jiangri Unirersity of Traditional Chinese Medicine,Jiangri,Nanchang 330006,China)

机构地区：[1]江西中医药大学,江西南昌330006 [2]江西中医药大学附属医院,江西南昌330006

出　　处：《中国中医急症》2023年第5期801-805,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：江西省中医药科技计划项目(2019A352)。

摘　　要：目的选用正交实验设计观察电针参数不同因素、水平对术后肠麻痹的临床疗效及胃肠激素水平的影响,选择最佳组合的电针治疗方案。方法纳入符合术后肠麻痹诊断的住院患者90例,使用L9(34)正交设计表对电针疗效影响的4种因素(穴位、波形、频率、时间)3水平试验设计方法进行,对患者进行针灸治疗;记录各组患者治疗前后胃动素(MTL)、胃泌素(GAS)、血管活性肠肽(VIP)结果的差值作为检验指标。结果治疗组胃肠功能恢复的时间上比较差异无统计学意义(P>0.05);各组治疗前后MTL、GAS、VIP的含量相比,有显著差异(P<0.01)。上述4因素对治疗效果影响依次是:频率为电针治疗效果的主要因素,波形为影响电针治疗的重要因素,穴位选择是电针治疗效果的重要因素,治疗时间为次要因素。结论不同电针方案对术后肠麻痹的临床疗效治疗效果明显,影响胃肠激素水平,最佳组合是针刺足三里、上巨虚、下巨虚,频率为15 Hz,电针波形为疏密波,治疗时间为30 min。Objective:To observe the effects of different factors and levels of electroacupuncture parameters on the clinical efficacy of postoperative intestinal paralysis and gastrointestinal hormone levels by orthogonal experimental design,and to select the optimal combination of electroacupuncture treatment.Methods:A total of 90 inpatients who met the diagnosis of postoperative intestinal paralysis were included,and the 3-level experimental design method of 4 factors(point,waveform,frequency and time)influencing the effect of electroacupuncture was used in Lo(3^(4))orthogonal design table.The patients were treated with acupuncture.The difference values of motilin(MTL),gastrin(GAS)and vasoactive intestinal peptide(VIP)before and after treatment were recorded as an indicator of observation.Results:There was no significant difference in the recovery time of gastrointestinal function between the treatment groups(P>0.05);there were significant differences in the contents of MTL,GAS and VIP among all groups before and after treatment(P<0.01).The above four factors influence the therapeutic effect,in turn,frequency was the main factor,waveform was the important factor,acupuncture point selection was the important factor,and treatment time was the secondary factor.Conclusion:Different electroacupuncture schemes have obvious clinical curative effect on postoperative intestinal paralysis,affecting gastrointestinal hormone levels.The best combination is acupuncture Zusanli,upper Juxu and lower Juxu,the frequency is 15 Hz,the electroacupuncture waveform is density wave,and the treatment time is 30 min.

关 键 词：术后肠麻痹 电针 正交试验设计 胃肠激素 

分 类 号：R245[医药卫生—针灸推拿学]