17例电针治疗机械通气重症患者肠内营养不耐受倾向性匹配分析  

Efficacy of Electroacupuncture in Feeding Intolerance of 17 Critically ill Patients Receiving Enteral Nutrition:A Retrospective Propensity Matching Analysis

作　　者：侯海鲲[1] 原源[1] 张园 张青[2] HOU Haikun;YUAN Yuan;ZHANG Yuan;ZHANG Qing(Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京积水潭医院,北京100035 [2]首都医科大学附属北京中医医院,北京100010

出　　处：《辽宁中医杂志》2023年第11期201-205,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：北京市属医院科研培育计划项目(PZ2021004)。

摘　　要：目的基于倾向性匹配分析电针治疗机械通气重症病人肠内营养不耐受的疗效。方法回顾性分析2014年8月—2021年1月北京积水潭医院重症监护室收治的重症机械通气肠内营养不耐受患者60例,根据治疗过程中是否应用电针疗法(连续3 d以上)分为电针治疗组和西药对照组。应用倾向性匹配分析法将两组各匹配17例,分别评估治疗前及治疗3 d后肠内营养喂养指标与腹胀便秘症状的改善情况。结果两组治疗3 d后肠内营养(eternal nutrition,EN)喂养率均有所提升但差异无统计学意义。两组胃残余量降低与升高及无变化的患者比例差异无统计学意义(P>0.05)。电针组治疗后胃残余量中位数第1天较治疗前胃残余量显著降低(P=0.02),第2、3 d治疗组胃残余量较治疗前差异无统计学意义(P=0.24、0.39),对照组胃残余量中位数第1~3 d较治疗前差异无统计学意义(P=0.22、0.24、0.45)。两组第1~3 d营养液入量中位数较治疗前均有显著性增加(P<0.05),两组EN喂养热量较治疗前显著性提高(P<0.05)。电针组与对照组第1~3 d营养液增量差异无统计学意义(P=0.93,0.91,0.92)。电针组3 d后患者腹胀便秘症状缓解15例(44.1%),对照组腹胀便秘缓解患者13例(38.2%),两组症状缓解率差异无统计学意义(P=0.36)。电针组平均缓解时间(2.76±1.72)个时间段,对照组平均缓解时间(2.83±1.57)个时间段,电针组腹部症状缓解时间快于对照组,差异有统计学意义(P=0.04)。结论电针组在第1天降低机械通气肠内营养不耐受重症患者胃残余量和改善腹部症状时效方面较单纯应用西药具有优势。Objective To evaluate the therapeutic effect of electroacupuncture on enteral nutrition(EN)intolerance in critical-ly ill patients with mechanical ventilation based on propensity matching analysis.Method:A retrospective analysis was conducted on 60 patients with severe mechanical ventilation EN intolerance admitted to the intensive care unit of Beijing Jishuitan Hospital from August 2014 to January 2021.They were divided into an electroacupuncture treatment group and a Western medicine control group based on whether electroacupuncture therapy was used during the treatment process(for more than 3 consecutive days).U-sing propensity matching analysis,two groups were matched with 17 cases in each to evaluate the improvement of EN feeding indi-cators and abdominal distension and constipation symptoms before and after 3 days of treatment.Results After 3 days of treatment,both groups showed an increase in EN feeding rates,but there was no significant difference.There was no significant statistical difference in the proportion of patients with decreased or increased gastric residual volume and no changes between the two groups(P>0.05).The median gastric residual volume in the electroacupuncture group decreased significantly on the first day compared to that before treatment(P=0.02),and there was no statistically significant difference in gastric residual volume on the second and third day compared to that before treatment(P=0.24,0.39).The median gastric residual volume in the Western control group showed no statistically significant difference on the first to third day compared to that before treatment(P=0.22,0.24,0.45).The median intake of nutrient solution on day 1~3 in both groups showed a significant increase compared to that before treatment(P<0.05),and the calorie intake of EN feeding in both groups was significantly increased compared to that before treatment(P<0.05).There was no significant difference in nutrient solution increment between the electroacupuncture group and the Western control group on day 1~3(P=0

关 键 词：电针 营养支持 重症监护病房 

分 类 号：R256.3[医药卫生—中医内科学]