生大黄联合新斯的明足三里穴位注射治疗急性胰腺炎并发肠麻痹:一项随机临床试验OA
Efficacy of Crude Rhubarb Combined with Neostigmine Acupoint Injection at Zusanli(ST36)in Acute Pancreatitis Complicated with Paralytic Ileus:A Randomized Controlled Trial
目的:基于中西医"腑气不通"与"微循环障碍"病机理论,探讨生大黄联合新斯的明于足三里穴位注射治疗急性胰腺炎(AP)合并肠麻痹的临床疗效与安全性.方法:本研究为前瞻性随机对照试验,选取 2024 年 3 月—2025 年 8 月福建医科大学附属闽东医院收治的 85 例 AP 并发肠麻痹患者为研究对象,分为对照组(常规西医治疗,28 例)、生大黄组(常规治疗+生大黄颗粒 30 g 胃管注入,28 例)、联合治疗组(生大黄+新斯的明足三里穴位注射 0.5 mg/穴,q12 h,29 例).主要终点为肠功能恢复时间;次要终点包括炎症标志物、器官损伤指标、总住院日及安全性事件.结果:3 组基线特征比较,差异无统计学意义(P>0.05);联合治疗组的肠功能恢复时间显著少于其他组,差异有统计学意义(P<0.05);治疗后,联合治疗组炎症指标、器官损伤指标、肠鸣音恢复时间、耐受全量肠内营养时间、住院天数等方面均优于其他两组,差异有统计学意义(P<0.05);所有患者均完成预设治疗疗程,研究期间无患者因不良事件退出,无失访病例.结论:生大黄与新斯的明穴位注射联合治疗能够显著促进 AP 患者肠功能恢复,有效减轻炎症反应,缩短住院时间,展现出良好的临床应用价值及安全性.
Objective:To evaluate the efficacy and safety of crude rhubarb combined with neostigmine acupoint injection at Zusanli(ST36),a treatment strategy informed by the Traditional Chinese Medicine(TCM)concept of"fu-qi obstruction"and the Western medical understanding of microcirculatory dysfunction,in patients with acute pancreatitis(AP)complicated by paralytic ileus.Method:In this prospective,randomized controlled trial,85 patients with AP and paralytic ileus were allocated to three groups:a control group(n=28)receiving conventional Western medical therapy;a rhubarb group(n=28)receiving conventional therapy+30 g of crude rhubarb granules via nasogastric tube;and a combination group(n=29)receiving conventional therapy,crude rhubarb,and bilateral neostigmine injection at Zusanli(0.5 mg per acupoint every 12 hours).The primary endpoint was time to recovery of intestinal function.Secondary endpoints included inflammatory markers,parameters of organ injury,total hospital stay,and adverse events.Result:There was no statistically difference in baseline characteristis of 3 groups(P>0.05).The comparison of baseline characteristics among the three groups of patients showed no statistically significant difference(P>0.05).The recovery time of intestinal function in the combined treatment group was significantly shorter than the other groups,and the difference was statistically significant(P<0.05).After treatment,the combined treatment group was significantly superior to the other two groups in inflammatory indicators,organ damage indicators,recovery time of bowel sounds,tolerance time to full enteral nutrition,and length of hospital stay,and the differences were statistically significant(P<0.05).All patients completed the preset treatment course.During the study period,no patients withdrew due to adverse events and no cases were lost to follow-up.Conclusion:The combination of crude rhubarb and neostigmine acupoint injection at Zusanli(ST36)significantly accelerates the recovery of intestinal function,mitigates systemic inflammation,and shortens hospital stay in patients with AP and paralytic ileus,demonstrating promising clinical utility and a favorable safety profile.
陆晶;郭超;刘兆云;赵燕琴
福建医科大学附属闽东医院消化内科 福建 福安 355000福建医科大学附属闽东医院消化内科 福建 福安 355000福建医科大学附属闽东医院消化内科 福建 福安 355000福建医科大学附属闽东医院消化内科 福建 福安 355000
急性胰腺炎肠麻痹生大黄新斯的明足三里穴位注射
Acute pancreatitisParalytic ileusCrude rhubarbNeostigmineZusanli(ST36)Acupoint injection
《中外医学研究》 2026 (10)
16-21,6
福建中医药大学校管科研课题(XB2024208)
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