The Role And Safty Study Of Transcutaneous Electrical Acupoint Stimulation At Zusanli On Organophosphorus Pesticide Poisoning Patients

Objectives: All patients were choosed from Emergency Department of our hospital According to the standard of diagnosis and treatment of organophosphorus pesticide poisoning, patients resieved repeated gastric lavage, catharsis to remove poison residues in the gastrointestinal tract, against the muscarinic symptoms of atropine, pralidoxime chloride recovery of cholinesterase activity, the protection of gastric mucosa and promote the metabolism of blood poison, necessary ventilator assisted breathing.At the same time we applicated transcutaneous electrical acupoint stimulation at Zusanli acupoint therapy. Observated catharsis effect 、 reduce vomiting adverse reaction effect 、protection of heart and liver and other organs and the incidence of adverse effect of reducing complications.We observed treatment response 、the cure rate, influence and monitoring the operation process of the body hemodynamics and wether dizziness, skin damage and other adverse events occured Evaluated the treatment effect and safety.Methods: 62 oral organophosphorus pesticide poisoning patients were choosed from 2013 September to 2014 December in the emergency department of Xingtai People’s hospital.Patients were divided into two groups :the test group and control group with 31 cases in each group.All patients were given comprehensive treatment accordance with the organic phosphorus pesticide poisoning treatment.The treatment included gastric lavage, catharsis clearance toxic residue in the gastrointestinal tract, against the muscarinic symptoms of atropine, pralidoxime chloride recovery of cholinesterase activity, the protection of gastric mucosa and promote the metabolism of blood poison, establishment of artificial airway, ventilator assisted breathing and blood dialysis treatment. The experimental group applicated transcutaneous electrical acupoint stimulation of bilateral Zusanli acupoint, 1 times every eight hours,30 minutes every time.The control group routinely use of cathartics and adsorbent.The indexes included: application of cathartics first stool time and black stool time, catharsis during daily defecation, reach atropinization time and the total amount of use of atropine, cholinesterase recovery time, respiratory failure treated with tracheal intubation, ventilator treatment rate.Observed the changes of serum CK, CK-MB, LDH 3 days after. Assessed the other important organ damagement darling cell recovery situation.The time- in-hospital 、death cases rate and cured rate of two groups of patients were observed. In the experimental group,the changes of heart rate(H), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MBP) and peripheral blood oxygen saturation(Sp O2) were observed at several time: before treatment, 1min, 5min after treatment. and observation of the treatment process Wether there has adverse events such as: local skin damage, muscle pain, dizziness were also observed.Through this way we evaluated the safety of this therapeutic technique.Results: Compared with the test group,the vomiting rate of the control group was significantly higher than that of the test group.There was significant difference between two groups{32.2%(10 cases) vs 9.7%(3 cases), P < 0.05}.With the two groups of patients the first time and first passed black stool time comparison, the test group was significantly shortened than that of control group, there was significant difference between two groups(hours:9.3 ± 3.6 vs 11.6±5.2, 11.3 ±5.3 vs 14.5±6.8, P<0.05); Defecation frequency during catharsis,the test group was higher than the control group(times/d:4.3± 0.53 vs 3.1±0.41, P<0.01); reach atropinization time, atropine use and total serum cholinesterase returned to half normal time were compared,the differences between the two groups were statistically significant(hours:4.2 ±2.8 vs 7.6±3.5, mg:66.3±22.8 vs 84.6±24.2, days:6.1±2.4 vs 8.3 + 3.9, P<0.01); the two groups of patients with ventilator treatment rate(13% vs 35%) and average hospitalization time(11.3±2.8 vs 13.4±4.2), the test group was better than in the control group, the difference had statistical significance(P<0.05); the two groups of patients after treatment for 3D determination of serum CK, CK-MB, LDH value changes of comparion, the experimental group was significantly better than the control group(u/L:925.1±130.2 vs 1252.1±159.3, 28.8±9.1 vs 35.2±12.6,223.9±28.9 vs 315.2±37.4, P<0.05);experimental group percutaneous electrical acupoint stimulation before treatment, 1min, 5min and after treatment: heart rate(H), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial blood pressure(MBP) and peripheral oxygen saturation(Sp O2) did not change significantly, there was no statistical difference between before treatment and after treatment.{heart rate(times /min):119.1±8.1,116.2±8.7,120.1±9.1 vs 118.2 ± 10.9, systolic blood pressure(mm Hg, 1 mm Hg = 0.133 k Pa): 118.8 ± 19.1,116.6 ± 16.0,118.8 ± 18.1 vs 115.6 ± 16.8, diastolic blood pressure(mm Hg): 80.9 ± 15.8, 78.5 ± 17.9,77.2 ± 18.2 vs 76.1 ± 17.2, mean arterial pressure(mm Hg): 96.7 ± 17.5,97.4 ± 18.5,98.0 ± 18.2 vs 95.9 ± 19.5, Sp O2 :(%): 93.3 ± 2.8,94.9 ± 3.2,94.2 ± 3.1 vs 94.2 ± 4.2), P> 0.05}.There was no adverse reactions such as local skin damage, syncope, muscle pain in the couse of transcutaneous electrical acupoint stimulation. All this indicating that the operation is safe.Conclusions:1 Oral organophosphorus pesticide poisoning patients who were recieved transcutaneous electric acupoint stimulation at Zusanli given the basic gastric lavage, laxative, and on the comprehensive treatment of combined treatment of traditional Chinese and Western medicine. Transcutaneous electric acupoint stimulation at Zusanli, has advantages of lower incidence of emesis, enhance the cathartic effect, promote gastrointestinal poison discharged as soon as possible, reduces total atropine used during hospitalization.2 Transcutaneous electric acupoint stimulation at Zusanli has shorten atropinization time, increase cholinesterase recovery time, protect theart and other important organs, shorten the hospitalization time, improve the cure rate, achieved good clinical effects.3 Effect of this operation on the body is small and no adverse reactions and dizziness and accident happens, It is a safe and effective treatment measures for clinical treatment of oral organophosphorus pesticide poisoning patients.It enhanced the clinical curative effect and provides a convenient, safe, effective method.