益气健脾针法修复急性胃肠损伤肠道屏障的临床研究

Clinical Study on the Repair of Intestinal Barrier of Acute Gastrointestinal Injury by Yiqi Jianpi Acupuncture Method

目的观察益气健脾针法修复急性胃肠损伤肠道屏障的临床疗效。方法70例脓毒症急性胃肠损伤患者随机分为治疗组与对照组各35例。对照组予西医常规治疗,治疗组在对照组治疗的基础上加用益气健脾针法治疗。两组疗程均为7 d。观察并比较两组患者治疗前与治疗第7天后的急性生理与慢性健康(APACHEⅡ)评分、器官功能衰竭评价(SOFA)评分、AGI分级、危重病腹胀中医辨证评分、腹内压、肠鸣音、肠脂肪酸结合蛋白、D-乳酸、二胺氧化酶情况。结果治疗后两组患者胃肠道症状改善,腹腔压减少,肠鸣音增加,APACHEⅡ评分、AGI分级、危重病腹胀中医辨证评分降低,治疗组改善程度均优于对照组(P<0.05);治疗组SOFA评分、肠脂肪酸结合蛋白、D-乳酸、二胺氧化酶数值下降(P<0.05)。结论益气健脾针法治疗脓毒症急性胃肠损伤可以改善患者的胃肠道功能和症状,降低肠道的通透性,减轻肠道缺血状态,其机制可能与修复患者肠黏膜屏障损伤相关。

Objective:To observe the effects of the repair of the intestinal barrier of acute gastrointestinal injury by Yiqi Jianpi acupuncture method.Methods:70 acute gastrointestinal injury of sepsis patients were randomly divided into the control group and the experimental group,35 cases in each group.The control group used conventional treatment methods;the experimental group was combined with Yiqi Jianpi acupuncture method on the basis of control group.Both groups were treated for 7 days.The changes of APACHEⅡscore,SOFA score,AGI grading,TCM syndrome differentiation score of critically ill abdominal distension,bowel sounds,intra-abdominal pressure and I-fatty acid-binding protein,D-lactic acid,diamine oxidase were observed and compared between before treatment and after the 7 th day.Results:After treatment,the gastrointestinal symptoms improved in both groups,the abdominal pressure decreased,and the intestinal chirping increased,the APACHEⅡscore,SOFA score,TCM syndrome differentiation score of critically ill abdominal distension decreased;the improvement of the experimental group was better than that of the control group(P<0.05);the levels of I-fatty acid-binding protein,D-lactic acid,diamine oxidase in the experimental group decreased(P<0.05).Conclusion:Yiqi Jianpi acupuncture method for acute gastrointestinal injury of sepsis can improve the patient’s gastrointestinal function and symptoms,reduce intestinal permeability and intestinal ischemia,and the mechanism may be related to repair of patient′s intestinal mucosa barrier damage.