Study on the effect of gastrointestinal three-needle acupuncture combined with Shenling Baizhu powder for the treatment of early enteral nutrition intolerance in critically ill patients
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摘要: 目的 探究胃肠三针联合参苓白术散治疗危重症患者早期肠内营养不耐受的效果。方法 纳入100例危重症受试者，随机分为对照组和试验组，对照组采取常规治疗以及对症治疗，试验组采用胃肠三针和参苓白术散联合治疗。干预1周后进行指标检测以及治疗效果评估。结果 治疗后，试验组的喂养不耐受指标分数较对照组明显降低(P < 0.05)，血清胃动素水平较对照组明显升高(P < 0.05)，营养指标水平变化较对照组更明显(P < 0.05)。结论 胃肠三针联合参苓白术散能够降低危重症患者早期肠内营养不耐受的发生率，联合治疗能够为危重症患者的治疗和康复提供有效支持。Abstract: Objective This study aims to evaluate the efficacy of a combination therapy involving gastrointestinal three-needle acupuncture, Shenling Baizhu powder in reducing early enteral nutrition intolerance among critically ill patients.Methods A total of 100 critically ill patients were randomly assigned to two groups: a control group receiving conventional and symptomatic treatment, and an experimental group receiving a combination of gastrointestinal three-needle acupuncture and Shenling Baizhu powder. After one week of intervention, various indicators were assessed to evaluate the treatment outcomes.Results Post-treatment, the experimental group exhibited a significantly lower feeding intolerance index compared to the control group. Additionally, the serum gastric motility index was significantly higher, and the nutritional index was significantly lower in the experimental group, with statistically significant differences observed between the two groups(P < 0.05).Conclusion The combination of gastrointestinal three-needle acupuncture with Shenling Baizhu powder can effectively reduce the incidence of early enteral nutrition intolerance in critically ill patients. This integrated approach offers valuable support for the treatment and recove.
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表 1 两组患者的临床资料比较
例，X±S 组别 例数 性别 年龄/岁 身高/cm 体重/kg 男 女 对照组 44 20 24 65.46±12.49 168.00±5.99 63.25±10.44 试验组 46 22 24 68.35±15.08 167.85±7.05 68.17±19.08 
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表 2 两组患者的感染情况及原始疾病比较
例(%) 指标 对照组(n=44) 试验组(n=46) 感染情况 是 30(68.18) 32(69.57) 否 14(31.82) 14(30.43) 脑血管意外 9(20.45) 11(23.91) 肾衰竭 3(6.82) 1(2.17) 心力衰竭 9(20.45) 10(21.74) 呼吸衰竭 6(13.64) 8(17.39) 创伤 8(18.18) 6(13.04) 休克 4(9.09) 3(6.52) 大型手术复苏 2(4.55) 3(6.52) 其他 3(6.82) 4(8.70)
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表 3 两组患者的机械通气时间、住院时间、APACHE-Ⅱ评分比较
X±S 组别 例数 机械通气时间/d 住院时间/d APACHE-Ⅱ评分/分 治疗前 治疗后 对照组 44 4.07±1.39 11.80±3.93 16.63±2.86 16.51±3.97 试验组 46 5.76±2.13 11.09±3.52 16.24±4.49 14.00±3.301) 与对照组比较，1)P < 0.05。
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表 4 两组患者治疗前后的AGI分级比较
例(%) 组别 例数 治疗前 治疗1周后 Ⅰ级 Ⅱ级 Ⅲ级 Ⅰ级 Ⅱ级 Ⅲ级 对照组 44 10(22.73) 23(52.27) 11(25.00) 23(52.27) 21(47.73) 0 试验组 46 12(26.09) 21(45.65) 12(26.09) 33(71.74)1) 10(21.74)1) 3(6.52)1) 与对照组比较，1)P < 0.05。
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表 5 两组患者的EFI、喂养耐受比较
例(%) 组别 例数 EFI 喂养耐受 对照组 44 21(47.73) 25(56.82) 试验组 46 12(26.09)1) 32(69.57) 与对照组比较，1)P < 0.05。
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表 6 两组患者的症状量化积分比较
分，X±S 组别 例数 症状量化积分 治疗1 d后 治疗3 d后 治疗7 d后 对照组 44 3.97±1.75 3.14±2.52 3.70±1.61 试验组 46 4.33±2.34 4.27±2.821) 2.05±1.561) 与对照组比较，1)P < 0.05。
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表 7 两组患者治疗前后血清胃动素水平比较
ng/L, X±S 组别 例数 治疗前 治疗后 对照组 44 211.74±7.75 241.67±6.59 试验组 46 208.82±10.31 292.49±8.311) 与对照组比较，1)P < 0.05。
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表 8 两组患者治疗前后营养指标比较
X±S 营养指标 对照组(44例) 试验组(46例) 治疗前 治疗后 治疗前 治疗后 ALB/(g/L) 29.19±3.37 29.11±3.06 27.44±3.37 34.98±2.411) PA/(mg/L) 125.45±39.78 200.39±84.41 126.97±69.14 267.74±44.751) 与对照组治疗后比较，1)P < 0.05。
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