脐针治疗腑实热结型急性胰腺炎的临床研究  

Clinical study of navel acupuncture in the treatment of acute pancreatitis with excess heat accumulation in the viscera syndrome

作　　者：陶源 张艳 张东暄 李达 顾树江 安金柱 张娇 TAO Yuan;ZHANG Yan;ZHANG Dongxuan;LI Da;GU Shujiang;AN Jinzhu;ZHANG Jiao(Department of Gastroenterology,Beijing Changping Traditional Chinese Medicine Hospital,Beijing 102200,China)

机构地区：[1]北京市昌平区中医医院脾胃病科,北京102200

出　　处：《北京中医药》2024年第12期1347-1351,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：北京市中医管理局县级中医医院“两专科一中心”建设项目;北京市昌平区中医医院学科发展项目(CZ202201,CZ202213)。

摘　　要：目的评价脐针治疗腑实热结型急性胰腺炎的临床疗效。方法回顾性分析北京市昌平区中医医院2017年1月—2023年12月收治的132例急性胰腺炎患者临床资料,根据治疗方法将患者分为观察组、对照组,各66例。对照组给予西医常规治疗,观察组在西医常规治疗基础上采用脐针疗法,针刺“四隅位”。比较2组疗效,临床表现,治疗前、治疗第3天、治疗结束后(即出院时)的实验室指标,中医证候积分,记录观察期间并发症发生情况。结果观察组总有效率高于对照组(χ2=4.181,P<0.05)。观察组腹痛消失、腹胀消失、肠鸣音恢复、首次排气、首次排便、腹部压痛消失时间均少于对照组(P<0.05)。治疗第3天和治疗结束时,观察组血清淀粉酶(Amy)、尿Amy、脂肪酶(LPS)、白细胞(WBC)、中性粒细胞比值(NE%)、C反应蛋白(CRP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、血清钙(Ca)均较治疗前改善(P<0.05);治疗第3天,对照组血清Amy、尿Amy、LPS、WBC、NE%、ALT、BUN均较治疗前改善(P<0.05)。治疗第3天和治疗结束时,观察组血清Amy、尿Amy、LPS、WBC、AST均低于对照组(P<0.05);治疗结束时,观察组NE%、CRP、ALT、BUN均低于对照组(P<0.05)。治疗第3天和治疗结束时,2组各项中医证候积分均较治疗前降低(P<0.05)。治疗第3天和治疗结束时,观察组腹满硬痛拒按、日晡潮热、呕吐及总积分低于对照组(P<0.05);治疗结束时,观察组各项中医证候积分均低于对照组(P<0.05)。观察组并发症发生率低于对照组(χ2=8.339,P<0.05)。结论脐针治疗急性胰腺炎疗效显著,能更快改善患者症状,减少并发症发生,提高治愈率。Objective To evaluate the clinical efficacy of navel acupuncture in the treatment of acute pancreatitis with excess heat accumulation in the viscera syndrome.Methods A retrospective analysis was conducted on the clinical data of 132 patients with acute pancreatitis admitted to Beijing Changping Traditional Chinese Medicine(TCM)Hospital from January 2017 to December 2023.According to the treatment method,the patients were divided into an observation group and a control group,with 66 cases in each group.The control group received conventional Western medicine treatment,while the observation group received navel acupuncture therapy in addition to conventional Western medicine treatment,with acupuncture at the“Four Corner Points”.Efficacy,clinical performance-related indicators,laboratory indicators,and TCM syndrome scores before treatment,on the third day of treatment,and at the time of discharge were observed and compared.The occurrence of complications during the observation period was also recorded.Results The total effective rate of the observation group was higher than that of the control group(χ2=4.181,P<0.05).The time for the disappearance of abdominal pain,bloating,recovery of bowel sounds,first flatulence,first defecation,and abdominal tenderness in the observation group was shorter than that in the control group(P<0.05).On the third day of treatment and at the end of treatment,the levels of serum amylase(Amy),urinary Amy,lipase(LPS),white blood cells(WBC),neutrophil ratio(NE%),C-reactive protein(CRP),alanine aminotransferase(ALT),glutamic-oxaloacetic transaminase(AST),blood urea nitrogen(BUN),and serum calcium(Ca)in the observation group all showed improvement compared to those before treatment(P<0.05).On the third day of treatment,the levels of serum Amy,urinary Amy,LPS,WBC,NE%,ALT,and BUN in the control group also improved compared to those before treatment(P<0.05).On the third day of treatment and at the end of treatment,the levels of serum Amy,urinary Amy,LPS,WBC,and AST in the observation group w

关 键 词：急性胰腺炎 脐针 腑实热结 四隅位 

分 类 号：R246.1[医药卫生—针灸推拿学]