针灸联合大承气汤加味保留灌肠治疗对呼吸衰竭有创机械通气患者血气指标、腹内压的影响

Effect of Acupuncture and Moxibustion Combined with Modified Dachengqi Decoction Retention Enema on Blood Gas Index and Intra-Abdominal Pressure in Patients with Respiratory Failure Undergoing Invasive Mechanical Ventilation

目的探讨针灸联合大承气汤加味保留灌肠治疗呼吸衰竭(RF)有创机械通气患者的临床效果。方法回顾性分析2022年3月—2024年3月南通市通州区中医院收治的66例RF有创机械通气患者的临床资料,依据治疗方案不同将其分为对照组和观察组,各33例。对照组采用常规西药治疗,观察组在对照组基础上联合针灸及大承气汤加味保留灌肠治疗,两组均持续治疗7 d。比较两组患者的血气指标、中医证候积分、腹内压、通气天数、住院时间及不良反应发生情况。结果治疗后,观察组的血氧分压为(89.65±6.12)mmHg,高于对照组的(82.47±5.75)mmHg,二氧化碳分压为(38.24±3.47)mmHg,低于对照组的(42.43±4.26)mmHg,组间差异有统计学意义(P<0.05);观察组的喘息、呼吸困难、气促、痰黄稠积分分别为(1.12±0.23)分、(0.85±0.12)分、(0.97±0.14)分、(0.89±0.15)分,均低于对照组的(1.41±0.26)分、(1.14±0.15)分、(1.25±0.17)分、(1.21±0.22)分,组间差异有统计学意义(P<0.05);观察组的腹内压为(1.56±0.25)mmHg,低于对照组的(2.29±0.34)mmHg,通气天数、住院时间分别为(5.32±1.05)d、(8.69±1.35)d,均短于对照组的(7.57±1.24)d、(10.78±1.53)d,组间差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论针灸联合大承气汤加味保留灌肠治疗RF有创机械通气患者的效果理想,可加快血气指标复常,降低中医证候评分,减低腹内压,缩短患者住院时间,安全可行。

Objective To investigate the clinical effect of acupuncture and moxibustion combined with modified Dachengqi Decoction retention enema in the treatment of patients with respiratory failure(RF)undergoing invasive mechanical ventilation.Methods The clinical data of sixty-six patients with RF undergoing invasive mechanical ventilation admitted to Tongzhou District Hospital of Traditional Chinese Medicine of Nantong City from March 2022 to March 2024 were retrospectively analyzed and were divided into a control group and an observation group according to different treatment plans,with 33 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with acupuncture and Dachengqi Decoction combined with retention enema on the basis of the control group.Both groups were treated continuously for 7 days.The blood gas index,TCM syndrome scores,internal abdominal pressure,ventilation days,hospital stay and adverse reactions were compared between the two groups.Results After treatment,the partial pressure of oxygen in the observation group was(89.65±6.12)mmHg,which was higher than(82.47±5.75)mmHg in the control group,and the partial pressure of carbon dioxide was(38.24±3.47)mmHg,which was lower than(42.43±4.26)mmHg in the control group,the differences between the groups were statistically significant(P<0.05);the scores of wheezing,dyspnea,shortness of breath and phlegm-yellow thickening in the observation group were(1.12±0.23)points,(0.85±0.12)points,(0.97±0.14)points and(0.89±0.15)points,respectively,which were lower than(1.41±0.26)points,(1.14±0.15)points,(1.25±0.17)points,(1.21±0.22)points in the control group,and the differences between the groups were statistically significant(P<0.05);the internal abdominal pressure in the observation group was(1.56±0.25)mmHg,which was lower than(2.29±0.34)mmHg in the control group,the number of days of ventilation and length of hospitalization were(5.32±1.05)d and(8.69±1.35)d,respectively,which were shorter than(7.57±1.24)d and(10.78±1.53)d in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Acupuncture and moxibustion combined with modified Dachengqi Decoction retention enema in the treatment of RF undergoing invasive mechanical ventilation patients is ideal,which can accelerate the normalization of blood gas index,reduce the TCM syndrome scores,reduce internal abdominal pressure,shorten the hospital stay of patients,and is safe and feasible.