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针刺治疗危重症患者急性胃肠损伤的 临床疗效评价
Clinical evaluation of acupuncture treatment of acute gastrointestinal injury in critically ill patients
收稿日期:2022-05-17  修订日期:2022-05-29
DOI:
关键词:  针灸  急性胃肠损伤  机械通气  炎症指标
Key Words:Acupuncture  Acute gastrointestinal injury  Mechanical ventilation  Inflammatory biomarker
基金项目:浙江省中医药科学研究基金项目(2020ZB257)
作者单位
蔚文龙 嘉兴市第一医院重症医学科浙江嘉兴 314001 
朱建刚 嘉兴市第一医院重症医学科浙江嘉兴 314001 
钟 林 嘉兴市第一医院重症医学科浙江嘉兴 314001 
吴莉菁 嘉兴市第一医院重症医学科浙江嘉兴 314001 
戴 晴 嘉兴市第一医院针灸科浙江嘉兴 314001 
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摘要:目的 观察针刺治疗对危重症患者急性胃肠损伤的临床疗效。方法 选取2019年10月至2021年4月嘉兴市第一医院收治的危重症急性胃肠损伤患者64例,采用随机数字表法将其分为常规组和针刺组,每组各32例。两组患者均给予西医常规治疗,针刺组患者在此基础上予针灸治疗,疗程为7d。比较两组患者治疗第1、4、7天的肠鸣音、白细胞计数(white blood cell count,WBC)、C反应蛋白(C–reactive protein,CRP)、降钙素原(procalcitonin,PCT)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)的变化,同时记录两组患者的喂养达标时间、机械通气时间、入住重症监护病房(intensive care unit,ICU)时间。结果 治疗第4天,针刺组患者的肠鸣音显著多于常规组,NLR显著低于常规组(P<0.05);治疗第7天,针刺组患者的WBC、CRP、PCT均显著低于常规组(P<0.05);针刺组患者的喂养达标时间、机械通气时间、入住ICU时间均显著短于常规组(P<0.05)。结论 针灸联合常规西医治疗,可改善危重症患者的肠道功能,减轻炎性反应,促进患者康复。
Abstract:Objective To observe the clinical effect of acupuncture on acute gastrointestinal injury in critically ill patients. Methods Sixty–four critically ill patients with acute gastrointestinal injury admitted to the First Hospital of Jiaxing from October 2019 to April 2021 were divided into routine group and acupuncture group by random number table, with 32 cases in each group. Patients in both groups were treated with routine western medicine, and patients in acupuncture group were treated with acupuncture on this basis, and the course of treatment was 7 days. The changes of bowel sounds, white blood cell count (WBC), C–reactive protein (CRP), procalcitonin (PCT), neutrophil to lymphocyte ratio (NLR) were compared between the two groups on the 1st, 4th and 7th day after treatment. The feeding time, mechanical ventilation time and admission time to intensive care unit (ICU) were recorded. Results On the 4th day of treatment, the bowel sounds in acupuncture group were significantly more than those in routine group, and the NLR was significantly lower than that in routine group (P<0.05). On the 7th day of treatment, WBC, CRP and PCT in acupuncture group were significantly lower than those in routine group (P<0.05). The feeding time, mechanical ventilation time and ICU stay time of patients in acupuncture group were significantly shorter than those in routine group (P<0.05). Conclusion Acupuncture combined with conventional western medicine treatment can improve the intestinal function of critically ill patients, reduce inflammatory reaction and promote the rehabilitation of patients.
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