危重患者胃肠功能障碍择时穴位热敷的干预研究

Intervention study of time-selected acupoint application in critically ill patients with gastrointestinal dysfunction

  • 摘要:
    目的 探讨择时穴位热敷对改善危重患者胃肠功能障碍的作用。
    方法 按照纳入标准选取80例危重患者, 并随机分为对照组39例和试验组41例。对照组采用传统方法治疗原发病,遵医嘱使用药物维护胃肠黏膜屏障,促进胃肠动力,必要时采取肠外营养进行营养支持。试验组在对照组基础上加用择时穴位热敷,每日1次。比较2组治疗前及治疗7 d后中医证候积分和急性生理学及慢性健康状况评分系统Ⅱ(APACHE Ⅱ) 评分,并比较治疗前、治疗第3天和治疗第7天患者血红蛋白、血清白蛋白与前白蛋白水平。记录试验组营养达标时间及肠鸣音恢复正常的时间。
    结果 治疗7 d后,试验组中医证候积分为(10.32±2.43)分,对照组为(14.18±2.11)分, 2组中医证候积分均下降,且试验组低于对照组,差异有统计学意义(P < 0.05)。治疗7 d后,试验组腹泻次数为(2.83±0.15)次/d, 对照组为(4.26±0.24)次/d, 试验组腹泻次数少于对照组,差异有统计学意义(P < 0.01)。试验组营养达标时间及肠鸣音恢复正常的时间均短于对照组,差异有统计学意义(P < 0.01)。治疗第7天,试验组和对照组血红蛋白、血清白蛋白与前白蛋白水平均较治疗前升高,且试验组高于对照组,差异有统计学意义(P < 0.05)。干预7 d后,试验组APACHE Ⅱ评分为(9.53±0.27)分,低于对照组的(14.52±0.63)分,差异有统计学意义(P < 0.01)。
    结论 择时穴位热敷能够减少患者腹泻次数,改善患者胃肠道功能,缩短营养达标及肠鸣音恢复时间,改善患者营养状况。

     

    Abstract:
    Objective To explore the effect of time-selected acupointhot compress in improving gastrointestinal dysfunction in critically ill patients.
    Methods According to the inclusion criteria, a total of 80 critically ill patients were selectedand randomly divided into control group(n=39) and test group(n=41). The control group was treated with traditional methods, drugs were used to maintain the gastrointestinal mucosal barrier and promote gastrointestinal motility according to the doctor's advice, and parenteral nutrition was used for nutritional support when it was necessary. On the basis of the control group, the test group was given time-selected acupoint hot compress for one time per day. Traditional Chinese medicine (TCM) syndrome scores and Acute Physiology and Chronic Health Status Scoring System Ⅱ (APACHE Ⅱ) scores were compared between the two groups before treatment and 7 days after treatment, and the levels of hemoglobin, serum albumin and prealbumin were compared between the two groups before treatment, 3 days and 7 days after treatment. The time of nutrition reaching the standard and the time of intestinal sound returning to normal status were recorded.
    Results After 7 days of treatment, TCM syndrome score of the test group were (10.32±2.43), and (14.18±2.11) in the control group, TCM syndrome scores of both groups decreased, and it was lower in the test group than that in the control group (P < 0.05). After 7 d of treatment, the diarrhea frequency of the experimental group was (2.83±0.15) times per day, which was less than (4.26±0.24) times per day in the control group (P < 0.01). The time of reaching the nutritional standard and the time to return to normal bowel sound in the test group were shorter than those in the control group (P < 0.01). On the 7th day of treatment, the levels of hemoglobin, serum albumin and prealbumin in test group and control group were higher than before treatment, and their levels in experimental group were higher than those in control group (P < 0.05). After 7 days of intervention, the APACHE Ⅱ score of the test group was (9.53±0.27), which was lower than (14.52±0.63) of the control group (P < 0.01).
    Conclusion Time-selected acupoint hot compress can reduce the frequency of diarrhea, improve the gastrointestinal function of patients, shorten the time of nutrition reaching the standard and the time of intestinal sound returning to normal status, and ameliorate patients' nutritional status.

     

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