电针支沟、足三里穴治疗粘连性肠梗阻:随机对照研究

Adhesive ileus treated by electroacupuncture at Zhigou(TE 6) and Zusanli(ST 36):a randomized controlled study

目的:评价电针支沟、足三里穴治疗粘连性肠梗阻的临床疗效,探讨穴位与非穴位作用差异。方法:采用前瞻性随机对照研究方案,将符合粘连性肠梗阻诊断标准的患者40例随机分为穴位组与非穴组,每组20例。在基础治疗的同时两组均给予电针,穴位组选取双侧支沟、足三里,非穴组选取双侧支沟、足三里旁开0.5～1cm处。每天针刺2次,共治疗4天。主要观察每日腹痛情况、腹胀症状改善时间、首次出现自行排便时间及进食固体食物时间等。结果:穴位组较非穴组可迅速缓解腹痛、减轻腹胀,在疼痛面谱量化评级、首次排气时间[(51.35±32.40)h vs(101.85±53.87)h]、首次排便时间[(82.70±57.27)h vs(154.70±145.28)h]、首次进食固体食物时间[(119.65±56.16)h vs(231.95±180.89)h]均有明显改善,差异具有统计学意义(P<0.05,P<0.01);在中转手术治疗人数、死亡人数及1年随访再入院治疗人数方面,两组差异无统计学意义(均P>0.05),但数据提示穴位组有改善趋势。结论:电针支沟、足三里穴治疗粘连性肠梗阻具有较好的临床疗效,可明显改善患者腹痛、腹胀不适症状,促进患者肠道蠕动,较非穴位组疗效有明显优势。

Objective To assess the clinical efficacy on adhesive ileus treated by electroacupuncture（EA） at Zhigou（TE 6） and Zusanli（ST 36）,and to explore the different effects of acupoint and non-acupoint.Methods Forty cases were randomized into an acupoint group and a non-acupoint group,20 cases in each one.At the same time of the basic treatment,in the acupoint group,EA was applied at bilateral Zhigou（TE 6） and Zusanli（ST 36）.In the non-acupoint group,EA was applied at the sites（that were neither on any meridian nor belonged to any acupoint） that were 0.5 to 1 cm lateral to Zhigou（TE 6） and Zusanli（ST 36） on both sides.Acupuncture was given twice a day,lasting for 4 days totally.The situation of abdominal pain,the time for the improvement in abdominal distention,the time of first voluntary defecation,the time of solid food intake and the others were observed.Results In the acupoint group,the abdominal pain and distention were relieved rapidly as compared with those in the non-acupoint group.The results of the assessment face scale（AFS）,the first anal exhaust time [（51.35±32.40） h vs（101.85±53.87） h],the first defecation time [（82.70±57.27） h vs（154.70±145.28） h] and the first solid food intake time [（119.65±56.16） h vs（231.95±180.89） h] were all remarkably improved as compared with those in the non-acupoint group,presenting the statistical significance（P0.05,P0.01）.Concer-ning the case number for the conversion to surgery,the death number and the number for the re-admission in 1 year follow-up visit,there was no significant difference in statistics between two groups（all P0.05）.But,the data suggested that the results were improved in tendency in the acupoint group.Conclusion EA at Zhigou（TE 6） and Zusanli（ST 36） achieves the good clinical efficacy on adhesive ileus.This therapy can remarkably improve abdominal pain and distention and promote the intestinal peristalsis for the patients and is superior to EA at non-acupoint.