耳穴压豆、针灸联合脐疗治疗不完全性肠梗阻临床研究

Clinical Research on Ear-pressing and Acupuncture Combined with Umbilicus-application Therapy in Treating Incomplete Intestinal Obstruction

目的:观察耳穴压豆、针灸联合脐疗治疗不完全性肠梗阻的临床疗效。方法:68例不完全性肠梗阻患者随机分对照组和治疗组各34例。对照组给予常规治疗;治疗组在对照组治疗基础上给予耳穴压豆(取交感、大肠、小肠穴,用王不留行籽固定在穴位上,间断指压,左右耳交替进行,每日左右耳各1次,共5 d)、针灸(取天枢、大横、足三里,针刺按虚补实泻法操作,共5 d)及脐疗(生大黄、芒硝、吴茱萸、生姜、葱白共研末,以蜂蜜调制,装入脐贴壳,贴敷于患者脐部神阙穴紧贴皮肤,每次2 h,每日2次,共5 d)。治疗后,比较两组患者临床疗效、主要症状积分、消化功能、血清胃泌素水平。结果:(1)治疗组有效率为93.1%(31/33),治愈率为69.7%(23/33);对照组有效率为78.1%(25/32),治愈率为50.0%(16/32),两组有效率和治愈率比较,差异均有统计学意义(P<0.05)。(2)治疗后,两组患者主要症状积分均低于本组治疗前;治疗组主要症状积分为(16.43±1.44)分,对照组主要症状积分为(28.32±0.79)分,治疗组低于同期对照组(P<0.05)。(3)治疗后,治疗组恢复排气时间为(80.56±11.34)h、恢复排便时间为(99.43±16.22)h、胃管拔除时间为(113.91±10.23)h、饮食恢复时间为(124.18±10.33)h、住院时间为(8.18±0.24)d,均低于同期对照组(P<0.05)。(4)治疗后,两组患者血清胃泌素水平均高于本组治疗前;治疗组血清胃泌素水平为(87.83±1.56)ng·L^(-1),对照组血清胃泌素水平为(73.32±0.29)ng·L^(-1),治疗组高于同期对照组(P<0.05)。结论:耳穴压豆、针灸联合脐疗治疗不完全性肠梗阻疗效显著,能有效促进消化功能恢复,缩短住院时间,提高血清胃泌素水平。

Objective:To investigate the efficacy of ear-pressing and body needle acupuncture combined with umbilicus-application therapy in the treatment of incomplete intestinal obstruction.Methods:68 patients with incomplete intestinal obstruction were randomized into two groups,with 34 cases in each group.The control group was given routine treatment,while the treatment group adopted ear-pressing therapy[the seed of cowherb being fixed at Jiaogan(AH6a),Dachang(CO 7)and Xiaochang(CO 6)acupoints,presseing the auricular points intermittently with fingers,alternately on the left and right ears,once a day for 5 days],body needle acupuncture therapy[selecting Tianshu(ST 25),Daheng(SP 15)and Zusanli(S T36)acupoints,manipulating needle with reinforcing and reducing techniques for 5 days]and umbilicus-application therapy[using a paste composed of Chinese herbal medicines including Rheum officinale,mirabilite,evodia rutaecarpa,fresh ginger and scallion,mixed with honey,being applied onto umbilical stickers,being adhered closely to Shenque(CV 8)acupoint on patient′s abdomen skin,for 2 hours each time,twice daily,for a total of 5 days].After treatment,the clinical efficacy,main symptom score,digestive function and serum gastrin level of the two groups were compared.Results:(1)The effective rate was 93.1%(31/33)and the cure rate was 69.7%(23/33)of the treatment group,while that was 78.1%(25/32)and 50.0%(16/32)respectively of the control group.There were significant differences between the two groups(P<0.05).(2)After treatment,the main symptom scores of the two groups were lower than those before treatment.The main symptom score of the treatment group was(16.43±1.44)points,while that of the control group was(28.32±0.79)points,which was lower than that of the control group significantly(P<0.05).(3)After treatment,in the treatment group,the recovery time of exhaust was(80.56±11.34)h,the recovery time of defecation was(99.43±16.22)h,the gastric tube removal time was(113.91±10.23)h,the diet recovery time was(124.18±10.33)h,and the hospitalization time was(8.18±0.24)d,which were all significantly lower than those of the control group during the same period(P<0.05).(4)After treatment,the serum gastrin levels of the two groups were higher than those before treatment;The serum gastrin level of the treatment group was(87.83±1.56)ng·L^(-1),which was significantly higher than(73.32±0.29)ng·L^(-1) of the control group(P<0.05).Conclusion:Ear-pressing and body needle acupuncture combined with umbilicus-application therapy are effective in the treatment of incomplete intestinal obstruction,which can effectively promote the recovery of digestive function,shorten the length of hospital stay and increase level of serum gastrin.