Objectives: To explore the effects of the combination of he-sea and front-mu 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 he-sea and front-mu points.
Methods: 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.
Results: 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 (P<0.05) except that on the 2nd 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 (P<0.05, P<0.01) when compared with those before treatment in the two groups, and these indicators in the observation group were lower (P<0.05) than those of the control group.
Conclusions: Acupuncture at the he-sea and front-mu 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.
目的: 观察合募配穴对危重症肠内营养喂养不耐受（ENFI）患者喂养达标率、腹内压、肠内营养耐受性评分、急性生理学和慢性健康状况评价Ⅱ（APACHE-Ⅱ）评分和胃肠功能损伤（AGI）等级的影响，评价合募配穴治疗ENFI的临床疗效。方法: 将70例ENFI患者随机分为对照组、治疗组各35例。对照组采用常规基础治疗联合肠内营养支持；治疗组在对照组治疗基础上取上脘、中脘、下脘、气海、关元及双侧内关、足三里、下巨虚、上巨虚、天枢、大横针刺，其中天枢、大横左右各为一组，分别接电针仪的一对电极，每次30 min，每日1次，连续7 d。观察两组患者治疗期间每日喂养达标人数，计算喂养达标率，记录治疗期间肠内营养耐受性评分、腹内压、APACHE-Ⅱ评分和AGI等级。结果: 治疗后两组肠内喂养达标率较治疗前升高，且治疗组除第2天以外肠内喂养达标率均高于对照组（P<0.05）；治疗后两组肠内营养耐受性评分、腹内压、APACHE-Ⅱ评分和AGI等级均较治疗前降低（P<0.05，P<0.01），且治疗组低于对照组（P<0.05）。结论: 合募配穴可以通过增加ENFI患者肠内营养喂养量，改善ENFI情况，提高患者喂养水平，促进胃肠功能恢复，有利于患者预后。.
Keywords: Combination of he-sea and front- mu points; Enteral feeding intolerance; Gastrointestinal function; Patients of critical illness.