摘要
目的观察电针足三里、上巨虚、天枢联合芒硝外敷治疗脓毒症患者胃肠功能障碍的临床疗效。方法将2014年6月～2017年1月收住我院的脓毒症并胃肠功能障碍患者66例,随机分为治疗组与对照组,每组33例。对照组给予常规西医治疗;治疗组在常规西医治疗基础上给予电针足三里、上巨虚、天枢及芒硝外敷治疗,比较两组患者急性生理及慢性健康状况评分Ⅱ(APACHEⅡ)、肠鸣音次数、达到目标喂养率、腹内压、腹围及28 d病死率情况。结果两组治疗后APACHEⅡ评分均较治疗前明显改善(P<0.05),治疗组治疗后APACHEⅡ评分与对照组比较,前者分值较低,但差异无统计学意义(P>0.05);两组治疗后肠鸣音次数明显增加(P<0.05),治疗组治疗后肠鸣音次数明显多于对照组(P<0.05)。与对照组比较,治疗组达到目标喂养率明显增高,差异有统计学意义(P<0.05);两组治疗后腹围及腹内压均较治疗前下降(P<0.05),治疗组治疗后腹围及腹内压均明显低于对照组(P<0.05)。与对照组比较,治疗组28 d病死率较低,但差异无统计学意义(P>0.05)。结论电针联合芒硝外敷可改善脓毒症患者的胃肠功能,但对于疾病的严重程度及28 d病死率无明显影响。
Objective To observe the clinical efficacy of electroacupuncture at Zusanli, Shangjuxu, Tianshu combined with mirabilite external application for the treatment of gastrointestinal dysfunction in patients with sepsis. Methods 66 patients with sepsis combined with gastrointestinal dysfunction who were admitted in our hospital from June 2014 to January 2017 were randomly divided into treatment group and control group, with 33 cases in each group. The control group was treated with conventional Western medicine. The treatment group was treated with electroacupuncture at Zusanli, Shangjuxu, Tianshu and combined with mirabilite external application based on the routine Western medicine treatment. The acute physiology and chronic health status score Ⅱ（APACHE Ⅱ）, the number of sounds, the target feeding rate, intra-abdominal pressure, abdominal circumference and 28-day mortality between the two groups were compared. Results The APACHE Ⅱ scores of the two groups were significantly improved after treatment（P〈0.05）. The APACHE Ⅱ scores in the treatment group were lower than those in the control group, but the difference was not statistically significant （P〉0.05）. The number of bowel sounds increased significantly after treatment （P〈0.05）. The number of bowel sounds in the treatment group was significantly higher than that in the control group （P〈0.05）. The target feeding rate was significantly higher in the treatment group than that of the control group, and the difference was statistically significant （P〈0.05）. The abdominal circumference and intra-abdominal pressure after treatment was lower than that before treatment. The abdominal circumference and intra-abdominal pressure in the treatment group after treatment was significantly lower than that of the control group（P〈0.05）. The 28-day mortality rate was lower in the treatment group than that of the control group, but the difference was not statistically significant （P〉0.05）. Conclusion Electroacupuncture combined with mirabilite can improve the gastrointestinal function of patients with sepsis, but has no significant effect on the severity of the disease and the 28-day mortality.
作者
张微
孟建标
ZHANG Wei;MENG Jianbiao(Intensive Care Unit,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China)
出处
《中国现代医生》
2018年第28期84-87,共4页
China Modern Doctor
基金
浙江省中医药科技计划项目(2016ZA015)
关键词
电针
芒硝外敷
脓毒症
胃肠道功能障碍
Electroacupuncture
External application of mirabilite
Sepsis
Gastrointestinal dysfunction
