A Randomized Controlled Clinical Study Of Acupuncture In The Auxiliary Treatment Of Sepsis Gastrointestinal Dysfunction

Obj ectiveIn this study,acupuncture at Shangwan,Zhongwan,Xiawan,bilateral Tianshu,Zusanli and Yanglingquan points was performed for patients with septic gastrointestinal dysfunction.This study aims to explore the effects of acupuncture on APACHE ? score,SOFA score,bowel sounds,abdominal circumference and intraperitoneal pressure,AGI g rade,GIF score,procalcitonin and C-reactive protein level,and mortality in sepsis patients with gastrointestinal dysfunction.Meanwhile,we hope to scientifically evaluate the safety of acupuncture in the treatment of septic gastrointestinal dysfunction and to provide some methods for the treatment of sepsis gastrointestinal dysfunction with integrated traditional Chinese and Western medicine via this study.Methods1.This is a prospecti-ve,randomized and controlled study.40 patients with sepsis gastrointestinal dysfunction admitted to the intensive care unit of Beijing Friendship hospital from November 2017 to February 2019 were enrolled.Forty patients were randomly divided into two groups.2.Both groups were given standard therapies:including active control of the primary disease;organ support treatment by means of ventilator,hemofiltration,vasoactive drugs and other means to maintain basic vital signs,symptomatic treatment of fluid resuscitation and anti-infection.When gastrointestinal dysfunction occurs,it is necessary to protect gastrointestinal barrier mucosa,regulate microecology,improve intestinal microcirculation,reduce gastrointestinal mucosal permeability,strengthen enteral nutrition and promote gastrointestinal motility.The treatment group was given acupuncture at Shangwan,Zhongwan,Xiawan,bilateral Tianshu,bilateral Zusanli and bilateral Yanglingquan acupoints once a time.3.The APACHE ? score,SOFA score,bowel sounds,abdominal circumference and intraperitoneal pressure,AGI grade,GIF score,procalcitonin and C-reactive protein levels were observed at the day of admission,the first day,the third day,the seventh day.4.The recorded data were analyzed by SPSS 19.0 statistical software to evaluate the efficacy and safety of acupuncture in the treatment of septic gastrointestinal dysfunction.Results1.Baseline statisticsThere was no statistically significant difference in age,sex and underlying diseases between the two groups(p>0.05).There was no statistically significant difference in the observation indexes between the two groups before treatment(p>0.05).The baseline was comparable.2.APACHE ? ScoreThe APACHE ? scores of the two groups had significant difference after treatment.The difference was statistically significant,the time effect f=12.11,p=0.00.However,the APACHE ? scores of different treatment methods had no significant changes after treatment,the grouping effect f=1.83,p=0.19.3.SOFA scoreThe SOFA scores of the two groups had no significant changes after treatment,the time effect f=1.74,p=0.19.The SOFA scores of different treatment methods also had no significant changes after treatment,the grouping effect f=2.14,p=0.15.4.Bowel soundsThe Bowel sounds of the two groups had significant changes after treatment,the difference was statistically significant,the time effect f=94.96,p=0.00.The Bowel sounds of different treatment methods also had significant changes after treatment,the grouping effect f=8.19,p=0.01.5.Abdominal circumferenceThe Abdominal circumference of the two groups had no significant changes after treatment,the time effect f=1.25,p=0.27.The Abdominal circumference of different treatment methods also had no significant changes after treatment,the grouping effect f=0.23,=0.64.6.Abdominal pressureThe Abdominal pressure of the two groups had significant changes after treatment,the time effect F=60.33,P=0.00.The Abdominal pressure of different treatment methods also had significant changes after treatment,the grouping effect f=10.20,p=0.00.7.Gastrointestinal function scoreThe AGI grade and GIF score of the two groups changed significantly after treatment.The time effect AGI grade:f=32.30,p=0.00,GIF score:f=24.30,p=0.00.There was no significant difference in AGI grade and GIF score between different treatments after treatment.The grouping effect AGI grade:f=1.11,p=0.30,GIF score:f=0.30,p=0.59.8.Inflammatory markersThere were significant changes in procalcitonin and C-reactive protein after treatment in both groups.The time-effect procalcitonin:f=3.59,p=0.03,C-reactive protein:f=5.19,p=0.01.There was no significant difference in procalcitonin and C-reactive protein between different treatment methods.The grouping effect of procalcitonin:f=0.98,p=0.33,C-reactive protein:f=1.68,p=0.20.9.MortalityThere was no significant difference in mortality between the two groups,with a chi-square value of 2.50,p=0.11.ConclusionAcupuncture at Shangwan,Zhongwan,Xiaiwan,bilateral Tianshu,Zusanli andYanglingquan points in patients with septic gastrointestinal dysfunction has two main functions.On the one hand,acupuncture at acupoints can promote gastrointestinal peristalsis,improve gastrointestinal motility,and make the intestinal sounds return to normal.On the other hand,acupuncture improves the gastrointestinal motility of patients with sepsisgastrointestinal dysfunction,gastrointestinal contents can be excreted quickly,thus reducing the intra-abdominal pressure of patients.These prevented bacterial and endotoxin translocation to a certain extent,and reduced the risk of further failure of other organs caused by increased abdominal pressure.