基于气机升降理论运用电针干预脓毒症患者急性胃肠损伤的临床研究  

Clinical Study on the Application of Electroacupuncture in the Intervention of Acute Gastrointestinal Injury in Patients with Sepsis Based on the Theory of Qi Ascending and Descending

作　　者：孙一凡 裴颖皓 陈明祺[1] 王醒[1] 戴林峰[1] Sun Yifan;Pei Yinghao;Chen Mingqi;Wang Xing;Dai Linfeng(The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中国中医急症》2024年第7期1178-1182,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家中医临床研究基地开放课题(JD2019SZ03)。

摘　　要：目的观察基于气机升降理论运用电针干预脓毒症急性胃肠损伤的临床安全性与有效性。方法53例患者按随机数字表法分为试验组27例对照组26例。两组均采用常规治疗,试验组在常规治疗基础上依据气机升降理论选用相关穴位加用电针治疗,疗程14 d。比较两组患者在治疗前和治疗第3、7、14天的胃肠功能指标、炎症指标、相关评分及28 d生存率之间的差异。结果试验组第7、14天急性胃肠损伤分级(AGI)低于同期对照组(P<0.05),治疗有效率优于对照组;试验组第3、7天腹腔内压力(IAP)低于同期对照组(P<0.05);试验组第3、7、14天肠鸣音高于同期对照组(P<0.05);试验组第3天肠内营养泵速高于同期对照组(P<0.05);试验组治疗后炎症指标均较前降低(P<0.05),对照组第7、14天C反应蛋白(CRP)、降钙素原(PCT)较前降低(P<0.05);试验组第3天胃肠功能障碍(GIF)评分低于同期对照组(P<0.05);治疗后两组患者急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分均较前降低(P<0.05);两组患者28 d生存率无明显差异(P>0.05)。结论基于气机升降理论运用电针干预脓毒症急性胃肠损伤,可有效改善患者胃肠功能,减轻炎症反应及脓毒症严重程度。Objective:To explore the clinical safety and effectiveness of electroacupuncture in the intervention of acute gastrointestinal injury(AGI)caused by sepsis based on the theory of qi ascending and descending.Meth⁃ods:A total of 53 patients were divided into an experimental group of 27 cases and a control group of 26 cases us⁃ing random number table method.Both groups received routine treatment,while the experimental group received relevant acupoints and electroacupuncture treatment based on the theory of Qi ascending and descending on the basis of routine treatment,with a course of 14 days.The differences in gastrointestinal function indicators,inflam⁃mation indicators,related scores,and 28 day survival rate between two groups before treatment,on the 3rd,7th,and 14th day after treatment were compared.Results:On the 7th and 14th day,the AGI grading in the experimen⁃tal group was lower than that in the control group(P<0.05);on the 3rd and 7th day,the intra-abdominal pressure(IAP)in the experimental group was lower than that in the control group during the same period(P<0.05);on the 3rd,7th,and 14th day,the intestinal sounds in the experimental group were higher than those in the control group during the same period(P<0.05);on the third day,the enteral nutrition pump speed in the experimental group was higher than that in the control group(P<0.05);after treatment,the inflammatory indicators in the experimen⁃tal group decreased compared with before treatment(P<0.05),while in the control group,C reactive protein(CRP)and procalcitonin(PCT)decreased on days 7 and 14 compared with before treatment(P<0.05);on the 3rd day,the gastrointestinal dysfunction(GIF)score of the experimental group was lower than that of the control group dur⁃ing the same period(P<0.05);after treatment,the acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ)and sequential organ failure assessment(SOFA)scores of both groups decreased compared with before treatment(P < 0.05);there was no significant difference in the

关 键 词：脓毒症 急性胃肠损伤 电针 气机升降理论 

分 类 号：R631[医药卫生—外科学]