粗针膻中穴埋针在慢性阻塞性肺疾病患者机械通气撤机中的应用价值

Value of long-term embedment of thick needle at Tanzhong point (膻中穴) in weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease

目的:探讨粗针膻中穴埋针在慢性阻塞性肺疾病(COPD)患者机械通气撤机困难时的应用价值。方法:将60例COPD并进行有创机械通气的患者按随机原则分为3组,每组20例。粗针埋针治疗组选用粗针针刺膻中穴,每次进针70 mm,留针4 h;传统毫针治疗组选用传统毫针针刺膻中穴,每次进针35 mm,留针0.5 h;两组均每周治疗5次,中间休息2 d,连续治疗4周。对照组只常规支持、对症治疗。记录治疗后1、2和4周呼吸机撤机成功率和撤机时间。结果:各组治疗后第1周呼吸机撤机成功率比较差异均无显著性(P均>0.05);第2周和第4周粗针埋针治疗组呼吸机撤机成功率(60%,75%)均显著高于对照组(30%,35%)和传统毫针治疗组(25%,30%),3组比较差异均有显著性(P均<0.05)。粗针埋针治疗组呼吸机撤机时间〔(18.8±14.9)d〕明显短于对照组〔(30.1±17.7)d〕和传统毫针治疗组〔(32.7±18.6)d〕,差异均有显著性(P均<0.05)。结论:COPD机械通气患者在撤机过程中采用粗针膻中穴埋针治疗能缩短,撤机时间且安全。

Objective： To study the value of longterm embedment of thick needle in Tanzhong point （膻中穴） in patients with chronic obstructive pulmonary disease （COPD） who had difficulty in weaning from mechanical ventilation （MV）. Methods： Sixty COPD patients after invasive MV were randomly divided into three groups： long -term embedment of thick needle group （embedment group）, traditional needle group and control group （each n= 20）. In embedment group, a thick needle was acupunctured 70 mm and embedded at Tanzhong point for 4 hours. In traditional needle group, a traditional filiform needle was acupunctured 35 mm at Tanzhong point for half an hour. Both two groups were treated 5 times weekly for 4 weeks with an interval of 2 days between 2 weeks. Only were routine treatments given to the patients in control group. The successful rate of weaning from MV at 1, 2 and 4 weeks and the time of weaning were recorded. Results： There were no significant differences of successful rate of weaning from MV at 1 week after treatment in the three groups （all P〉0. 05）. The successful rates of weaning from MV of embedment group （60%, 75%） were significantly higher than those of control group （30%, 35%） and traditional needle group （25%, 30%） in the 2 nd and 4 th week after treatment （all P〈0.05）. MV weaning time of emdedment group [（18.8±14.9） days3 was significantly shorter than those of control group and traditional needle group [（30.1 ± 17.7） days and （32.7± 18.6） days, respectively, both P（0. 053. Conclusion： Long -term embedment of thick needle at Tanzhong point is a kind of safe, easy and effective methods in weaning from MV in COPD patients.