Objective: To observe the clinical effect of electroacupuncture (EA) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with gastrointestinal dysfunction.
Methods: A total of 100 patients with AECOPD complicated with gastrointestinal dysfunction were randomly divided into an EA group (50 cases, 2 cases dropped off, 1 case excluded) and a medication group (50 cases). Both groups were treated with symptomatic and supportive treatment such as low flow oxygen, nebulized inhalation of short-acting β2 agonist (SABA) or short-acting muscarinic antagonist (SAMA) combined with inhaled corticosteroid (ICS). The EA group was treated with EA at Zusanli (ST 36), Yinlingquan (SP 9), Zhongwan (CV 12), Shuifen (CV 9), Tianshu (ST 25), Chize (LU 5) and Lieque (LU 7), with discontinuous wave, 2 Hz in frequency, 30 min each time, once a day. In the medication group, oral mosapride citrate tablets were given, 3 times a day, 5 mg each time. Both groups were treated for 5 d. Before and after treatment, the gastrointestinal symptom rating scale (GSRS) score was observe, serum procalcitonin (PCT), C-reactive protein (CRP), and plasma oxygenation index (PaO2/FiO2) were detected, and patient satisfaction degree was evaluated in the two groups.
Results: Compared with before treatment, except for diarrhea dimension in the medication group, the total scores and each dimension scores of GSRS were decreased (P<0.05), serum PCT and CRP were decreased (P<0.05), plasma PaO2/FiO2 was increased (P<0.05) in the two groups after treatment. After treatment, in the EA group, the total score and abdominal pain, dyspepsia, constipation and diarrhea scores of GSRS were lower than those in the medication group (P<0.05), meanwhile serum PCT and CRP were lower and plasma PaO2/FiO2 was higher than those in the medication group (P<0.05). The improvement of gastrointestinal symptoms, life quality and overall satisfaction degree in the EA group were superior to those in the medication group (P<0.05).
Conclusion: EA could improve the symptoms of patients with AECOPD complicated with gastrointestinal dysfunction, reduce inflammatory response, improve oxygenation and patient satisfaction degree.
目的：探讨电针干预慢性阻塞性肺疾病急性发作期（AECOPD）合并胃肠功能障碍的临床疗效。方法：将100例AECOPD合并胃肠功能障碍患者随机分为电针组（50例，脱落2例、剔除1例）和药物组（50例）。两组均予低流量吸氧、短效β2激动剂（SABA）或短效胆碱受体拮抗剂（SAMA）联合吸入型糖皮质激素（ICS）雾化吸入等对症及支持治疗。电针组予电针刺激足三里、阴陵泉、中脘、水分、天枢、尺泽、列缺，予断续波，频率2 Hz，每次30 min，每日1次；药物组予口服枸橼酸莫沙必利片，每日3次，每次5 mg。两组均治疗5 d。观察两组患者治疗前后胃肠道症状评定量表（GSRS）评分，检测两组患者治疗前后降钙素原（PCT）、C反应蛋白（CRP）、氧合指数（PaO2/FiO2），并评价患者满意度。结果：与治疗前比较，除药物组腹泻维度，两组治疗后GSRS总分及各个维度评分均降低（P<0.05），PCT、CRP降低（P<0.05），PaO2/FiO2升高（P<0.05）；治疗后，电针组GSRS总分及腹痛、消化不良、便秘、腹泻评分均低于药物组（P<0.05），PCT、CRP低于药物组（P<0.05），PaO2/FiO2高于药物组（P<0.05）。电针组患者胃肠道症状改善、生活质量改善及总体满意度优于药物组（P<0.05）。结论：电针可改善AECOPD合并胃肠功能障碍患者症状，降低机体炎性反应，改善氧合情况，提升患者满意度。.
Keywords: acute exacerbation of chronic obstructive pulmonary disease; electroacupuncture; gastrointestinal dysfunction; gastrointestinal symptom rating scale (GSRS); randomized controlled trial (RCT).