Clinical observation of abdominal acupuncture combined with Dachaihu decoction in treating sepsis gastrointestinal dysfunction
10.3969/j.issn.1008-9691.2024.06.004
- VernacularTitle:腹针联合大柴胡汤治疗脓毒症胃肠功能障碍的临床疗效观察
- Author:
Yuanyuan ZENG
1
;
Hefei HUANG
;
Xiaohong PENG
;
Yaxiu HUANG
;
Yonglian HUANG
;
Dongjie CHEN
;
Shaoping LI
;
Ping WANG
Author Information
1. 北京中医药大学深圳医院(龙岗)重症监护室,广东 深圳 518172;北京中医药大学,北京 100029
- Publication Type:Journal Article
- Keywords:
Sepsis with gastrointestinal dysfunction;
Dachaihu decoction;
Abdominal acupuncture;
Clinical observation
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(6):659-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical efficacy of abdominal acupuncture combined with Dachaihu decoction in the treatment of gastrointestinal dysfunction in sepsis.Methods A prospective randomized controlled study was conducted.A total of 90 patients with sepsis and gastrointestinal dysfunction admitted to Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine from December 2020 to May 2023 were selected as the research subjects.Patients were divided into a control group,a traditional Chinese medicine treatment group,and a comprehensive treatment group using a random number table method,with 30 cases in each group.After admission,all three groups received routine western medicine treatment,while the control group received a triple active capsule of mosapride citrate and bifidobacteria in addition to routine treatment;The traditional Chinese medicine treatment group was treated with Dachaihu decoction(consisting of Radix bupleuri 40 g,Scutellaria baicalensis 15 g,Pinellia ternata 15 g,Paeonia lactiflora 15 g,Fructus Aurantii 20 g,Jujube 15 g,Rhubarb 10 g,and Ginger 25 g)in addition to conventional treatment.This regimen involved one daily dose divided into 3 administrations.The comprehensive treatment group was treated with abdominal acupuncture in addition to the traditional Chinese medicine treatment group.Abdominal acupuncture adopts the Bo's abdominal acupuncture therapy,with a plan to select acupoints in Zhongwan,Xiawan,Qihai,Guanyuan,Daheng,Guanmen,Tianshu,and Taiyi.Acupuncture is administered once a day for 20 minutes each time.All 3 treatment groups have a duration of 8 days.Observe three groups of acute physiology and chronic health evaluationⅡ(APACHEⅡ),traditional Chinese medicine syndrome score,gastrointestinal dysfunction score,serum intestinal fatty acid binding protein(I-FABP),Occludin,zonula occludens-1(ZO-1),lipopolysaccharide(LPS),Toll like receptor 4(TLR4),interleukin-6(IL-6),procalcitonin(PCT),and nuclear factors-κB(NF-κB)before and after treatment changes in level.Record 3 groups of 28-day mortality,mechanical ventilation time,intensive care unit(ICU)hospitalization time,and total hospitalization time.Results On the 4th and 8th day of treatment,the APACHEⅡscore,gastrointestinal dysfunction score,traditional Chinese medicine syndrome score,and serum I-FABP,Occludin,ZO-1,LPS,TLR4,IL-6,PCT,NF-κB of three groups showed a significant downward trend,reaching a trough after 8 days of treatment,and the reduction in the comprehensive treatment group and the traditional Chinese medicine treatment group was more significant than that in the control group.The reduction in the comprehensive treatment group was more significant than those in the traditional Chinese medicine treatment group[APACHEⅡscore:13.37±4.54 vs.16.28±5.36,traditional Chinese medicine syndrome score:15.37±5.69 vs.18.72±6.34,gastrointestinal dysfunction score:6.22±1.56 vs.7.17±1.93,I-FABP(ng/L):8.38±2.69 vs.10.62±3.24,Occludin(ng/L):64.72±9.58 vs.75.66±11.45,ZO-1(ng/L):26.38±4.39 vs.30.26±5.77,LPS(EU/L):26.23±5.17 vs.34.52±7.41,TLR4(μg/L):7.47±2.63 vs.10.37±4.45,IL-6(ng/L):36.37±11.34 vs.43.69±12.56,PCT(μg/L):3.16±1.83 vs.6.38±3.25,NF-κB(μg/L):6.84±3.46 vs.10.43±5.65,all P<0.05].The mechanical ventilation time,ICU hospitalization time,and total hospitalization time of the comprehensive treatment group were all shorter than those of traditional Chinese medicine group and the control group[mechanical ventilation time(days):7.12±1.97 vs.8.29±2.23,9.68±2.87,ICU hospitalization time(days):9.27±3.22 vs.11.42±3.78,13.65±4.27,total hospitalization time(days):14.31±3.97 vs.16.65±4.74,19.54±5.33,all P<0.05].There was no statistically significant difference in the 28 day mortality among the comprehensive treatment group,traditional Chinese medicine treatment group,and control group[23.33%(7/30),33.33%(10/30)vs.46.67%(14/30),both P>0.05].Conclusion Dachaihu decoction can improve gastrointestinal function and clinical symptoms in patients with sepsis,the combination of Dachaihu decoction and abdominal acupuncture can more effectively promote gastrointestinal function recovery,reduce gastrointestinal mucosal damage,inhibit inflammatory reactions,shorten hospitalization time,and alleviate the condition.
