Yueyang Hospital of Integrated Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
Zhen Ci Yan Jiu. 2024 Jan 25;49(1):64-70. doi: 10.13702/j.1000-0607.20221172.
To explore the effects of the combination of -sea and front- points on the feeding compliance rate, the intra-abdominal pressure, the enteral nutrition tolerance score, the score of acute physiological and chronic health evaluation (APACHE)-Ⅱ and gastrointestinal function impairment grade in the patients with enteral nutrition feeding intolerance (ENFI) of critical illness and evaluate clinical effect on ENFI after acupuncture at the sea and front- points.
Seventy patients of ENFI were randomized into a control group and an observation group, 35 cases in each one. In the control group, the patients were treated with routine regimen combined with intestinal nutrition support. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Shangwan (CV13), Zhongwan (CV12), Xiawan (CV10), Qihai (CV6) and Guanyuan (CV4), as well as bila-teral Neiguan (PC6), Zusanli (ST36), Xiajuxu (ST39), Shangjuxu (ST37), Tianshu (ST25) and Daheng (SP15). Of those acupoints, ST25 and SP15 on the same side were attached to one pair of electrodes (20 Hz/100 Hz). Acupuncture was delivered once daily, 30 min each time and for consecutive 7 days. During treatment, the numbers of the cases up to the feeding standard were observed everyday to calculate the feeding compliance rate. The score of enteral nutrition tolerance, the intra-abdominal pressure, the score of APACHE-Ⅱ and the level of acute gastriointestinal injury(AGI) grading were recorded.
After treatment, the enteral feeding compliance rate was increased in comparison with that before treatment in the two groups, and the rate in the observation group was higher than that of the control group (0.05) except that on the 2 day. The score of the enteral nutrition tolerance, the intra-abdominal pressure, the score of APACHE-Ⅱ and the level of AGI were all reduced (0.05, 0.01) when compared with those before treatment in the two groups, and these indicators in the observation group were lower (0.05) than those of the control group.
Acupuncture at the -sea and front- points relieves the conditions of ENFI, improves the feeding and the recovery of gastrointestinal function, and benefits the prognosis through increasing the amount of enteral nutrition in ENFI patients.
探讨海、前线穴位结合对肠内营养不耐受（ENFI）危重病患者喂养依从率、腹腔内压、肠内营养耐受评分、急性生理与慢性健康评估（APACHE）-Ⅱ评分和胃肠功能障碍分级的影响，并评价针刺海、前线穴位对 ENFI 的临床疗效。
将 70 例 ENFI 患者随机分为对照组和观察组，每组 35 例。对照组患者采用常规方案联合肠内营养支持治疗。观察组在对照组治疗的基础上，采用针刺上脘（CV13）、中脘（CV12）、下脘（CV10）、气海（CV6）、关元（CV4）及双侧内关（PC6）、足三里（ST36）、下巨虚（ST39）、上巨虚（ST37）、天枢（ST25）和大横（SP15）。其中，双侧 ST25 和 SP15 连接一对电极（20 Hz/100 Hz）。每日针刺 1 次，每次 30 min，连续治疗 7 天。治疗期间，每天观察达到喂养标准的病例数，计算喂养依从率。记录肠内营养耐受评分、腹腔内压、APACHE-Ⅱ评分和急性胃肠损伤（AGI）分级水平。
治疗后，两组患者的肠内喂养依从率均较治疗前提高，观察组在第 2 天除外，均高于对照组（P<0.05）。两组患者肠内营养耐受评分、腹腔内压、APACHE-Ⅱ评分和 AGI 分级均较治疗前降低（P<0.05），观察组均低于对照组（P<0.05）。
针刺海、前线穴位可改善 ENFI 患者的病情，提高喂养和胃肠功能恢复，增加肠内营养量，有利于改善预后。
