电针联合益生菌治疗重度颅脑损伤合并胃肠功能障碍的疗效观察OA

Objective To observe the clinical efficacy of electroacupuncture combined with probiotics in the treatment of severe traumatic brain injury(sTBI)complicated with gastrointestinal dysfunction.Method Ninety patients with sTBI complicated with gastrointestinal dysfunction were enrolled and randomly divided,using a random number table,into an electroacupuncture group,a probiotic group,and a combination group,with 30 cases in each group.On the basis of enhanced recovery after surgery(ERAS),patients in the electroacupuncture group received electroacupuncture,those in the probiotic group received oral probiotics,and those in the combination group received electroacupuncture combined with oral probiotics,starting on the day of surgery.Changes before and after treatment in modified postoperative gastrointestinal dysfunction(PGD)traditional Chinese medicine(TCM)syndrome scores,gastrointestinal dysfunction scores(GIDS),gastrointestinal function biomarkers[serum gastrin(GAS)and motilin(MOT)],and biomarkers of acute gastrointestinal injury[serum endotoxin(ET),diamine oxidase(DAO),and D-lactate(LAC)]were observed.Recovery time of bowel sounds,time to first flatus,and time to first defecation were compared among the three groups.Clinical efficacy and adverse reactions were also evaluated.Result After treatment,TCM syndrome scores and GIDS scores were significantly lower than before treatment in all three groups.There were statistically significant differences among groups(P＜0.05),with the combination group showing significantly lower scores than the other two groups(P＜0.05).Significant differences were observed among the three groups in recovery time of bowel sounds,time to first flatus,and time to first defecation after treatment(P＜0.05),all of which were shorter in the combination group than in the electroacupuncture group and the probiotic group(P＜0.05).After treatment,serum levels of GAS and MOT were significantly higher than before treatment in all three groups(P＜0.05);intergroup comparisons showed statistically significant differences(P＜0.05),with the combination group having higher levels than the other two groups(P＜0.05).Serum levels of ET,DAO,and LAC were significantly lower after treatment in all three groups(P＜0.05),with the combination group showing significantly lower levels than the other two groups(P＜0.05).There were statistically significant differences in overall clinical efficacy among the three groups(P＜0.05),and the combination group demonstrated superior efficacy compared with the other two groups(P＜0.05).No serious adverse reactions leading to treatment withdrawal occurred in any group.Conclusion Electroacupuncture combined with probiotics is effective in improving gastrointestinal function in patients with severe traumatic brain injury and is superior to electroacupuncture or probiotic therapy alone.