生大黄穴位贴敷联合鼻饲在重症急性胰腺炎并发麻痹性肠梗阻患者中的应用

Application of raw rhubarb acupoint sticking with nasal feeding therapy among severe acute pancreatitis patients complicated with the paralytic ileus

目的：观察生大黄穴位贴敷联合鼻饲对重症急性胰腺炎（SAP）并发麻痹性肠梗阻患者的治疗效果。方法选取2012年7月—2014年4月在浙江省中医院和浙江大学医学院附属第一医院消化内科收治住院的 SAP 患者40例,按随机数字表随机分为观察组和对照组。两组均给予相同常规抗感染、补液等治疗,观察组入院时即给予生大黄神阙穴贴敷联合鼻饲治疗,对照组使用安慰剂神阙穴贴敷联合鼻饲。观察入院后患者肠鸣音恢复时间、首次自行排便时间、血淀粉酶恢复时间、局部并发症、病死率。结果观察组肠鸣音恢复时间、首次排便时间、血淀粉酶恢复时间分别为（2.85±1.04）,（3.55±1．32）,（8.85±2.30）d,均低于对照组,差异有统计学意义（t 值分别为2.226,2.332,2.067；P＜0.05）。观察组出现局部并发症1例,低于对照组7例,差异有统计学意义（χ2=5.625,P＜0.05）。两组患者的病死率比较差异无统计学意义（P＞0.05）。结论生大黄穴位贴敷联合鼻饲可缩短麻痹性肠梗阻的持续时间,促进肠蠕动恢复,降低并发症,提高临床综合疗效且临床操作方便,有护理应用推广的价值。

Objective To observe curative effect of rhubarb acupoint sticking with nasal feeding therapy among severe acute pancreatitis （SAP） patients complicated with the paralytic ileus. Methods During July 2012 to April 2014 in Gastroenterology Department in Zhejiang Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Zhejiang University, a total of 40 SAP inpatients were divided into experimental group and control group by random number table. All patients in the two groups received routine anti-infection, fluid infusion treatment, but the patients of experimental group underwent rhubarb acupoint sticking of Shenque Point with nasal feeding therapy while patients were taken placebo of Shenque point and nasal feeding therapy in the control group. We observed patient′s recovery time of bowl sound, time of first self defecation, recovery time of hemodlastase, local complication and mortality in two groups. Results The recovery time of bowl sound, time of first self defecation, recovery time of hemodlastase were （2. 85 ± 1. 04）, （3. 55 ± 1. 32） and （8. 85 ± 2. 30） d in the experimental group lower than these of the control group （ t =2. 226,2. 332,2. 067, respectively;P 〈 0. 05）. There were one case of local complication in the experimental group compared with 7 cases in the control group （χ2 = 5. 625,P 〈 0. 05）. The difference was no statistic for mortality between two groups （P 〉 0. 05）. Conclusions Rhubarb acupoint sticking with nasal feeding therapy can minimize the lasting time of paralytic ileus, reduce complication, enhance peristalsis function and clinical effect and operation, and is worth of clinical promotion.