摘要
目的观察早期电针尺泽穴及上巨虚穴对急性呼吸窘迫综合征(ARDS)患者临床疗效及呼吸动力学的影响.方法采用前瞻性随机对照研究方法.选择2020年12月至2022年9月入住浙江省立同德医院急诊医学科的142例ARDS患者作为研究对象,7例患者因疾病迅速恶化剔除,3例因撤销知情同意退出,最后132例入组.按随机数字表法将患者分为电针组和常规治疗组,每组66例.常规治疗组给予ARDS常规治疗,电针组在此基础上联合电针尺泽穴及上巨虚穴治疗,治疗时间为30 min.比较两组主要疗效指标60d病死率和次要疗效指标住院时间、28d内未使用呼吸机时间、机械通气时间,以及呼吸力学和氧合指标吸入氧浓度(FiO_(2))、潮气量(VT)、呼气末正压(PEEP)、平台压(Pplat)、肺静态顺应性(Cst)、氧合指数(PaO_(2)/FiO_(2))的差异,并绘制Kaplan-Meier生存曲线,比较两组60d内累积生存率的差异.结果电针组60d内病死率低于常规治疗组[33.33%(22/66)比40.91%(27/66)],但差异无统计学意义(P>0.05),住院时间较常规治疗组明显缩短(d:25.09±11.57比30.21±15.94,P<0.05),28 d内未使用呼吸机时间较常规治疗组明显延长(d:10.06±7.35比7.67±5.72,P<0.05).电针组和常规治疗组机械通气时间比较差异无统计学意义(d:15.70±9.05比18.39±9.55,P>0.05).治疗72h后,电针组FiO_(2)、VT、PaCO_(2)均明显低于常规治疗组[FiO_(2):0.39±0.07比0.44±0.09,VT(mL/kg):6.27±0.74比6.62±0.74,PaCO_(2)(mmHg,1 mmHg≈0.133 kPa):39.94±4.52比41.95±4.19,均P<0.05].结论电针尺泽穴、上巨虚穴能有效缩短ARDS病程,改善预后,这可能与电针治疗对呼吸动力学的改善有关.
Objective To evaluate the effect of electroacupuncture at Chize and Shangjuxu on the prognosis and respiratory dynamics in patients with acute respiratory distress syndrome(ARDS).Methods A prospective randomized controlled study was conducted to collect patients with ARDS admitted to the Department of Emergency Medicine of Tongde Hospital of Zhejiang Province from December 2020 to September 2022.A total of 142 patients with ARDS from the Department of Emergency Medicine of Tongde Hospital of Zhejiang Province were selected for this study.Seven patients were excluded due to rapid deterioration,3 patients withdrew the informed consent,and finally 132 patients were enrolled.According to the order of enrollment,they were randomly divided into the electroacupuncture group and the conventional treatment group based on the random number table.The conventional treatment group received conventional treatment for ARDS,while the electroacupuncture group combined with electroacupuncture at Chize and Shangjuxu,the treatment lasted for 30 minutes.The mortality at day 60 and secondary efficacy indicators such as hospital stay,ventilator-free days at 28 day,and mechanical ventilation time of two groups were compared,and the indicators of respiratory mechanics and oxygenation such as inhalation oxygen concentration(FiO_(2)),tidal volume(VT),positive end-expiratory pressure(PEEP),plateau pressure(Pplat),lung static compliance(Cst),oxygenation index(PaO/FiO_(2))were also compared.Then the Kaplan-Meier survival curves were drawn to compare the differences in cumulative survival rates within 60 days between the two groups.Results The mortality at day 60 in the electroacupuncture group was lower than that in the conventional treatment group[33.33%(22/66)vs.40.91%(27/66)],but the difference was not statistically significant(P>0.05),and the hospital stay in the electroacupuncture group was significantly shorter than that in the conventional treatment group(days:25.09±11.57 vs.30.21±15.94,P<0.05).The ventilator-free days at 28 days in
作者
白祥琰
张亮
周江通
李怡茜
杨雪
Bai Xiangyan;Zhang Liang;Zhou Jiangtong;Li Yiqian;Yang Xue(Department of Emergency Medicine,Tongde Hospital of Zhejiang Province,Hangzhou 310012,Zhejiang,China;Department of Pharmacy,Pan'an Traditional Chinese Medicine Hospital,Jinhua 322305,Zhejiang,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2023年第6期647-650,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省中医药科技计划(2020ZB057)。
关键词
电针
尺泽穴
上巨虚穴
急性呼吸窘迫综合征
Electroacupuncture
Chize
Shangjuxu
Acute respiratory distress syndrome
