针刺联合益生菌治疗急性缺血性卒中合并胃肠功能障碍的疗效观察OA
Observation of the therapeutic efficacy of treating acute ischemic stroke complicated with gastrointestinal dysfunction with acupuncture plus probiotics
目的 观察针刺联合多联益生菌治疗急性缺血性卒中合并胃肠功能障碍的临床疗效.方法 选择急性缺血性卒中合并胃肠功能障碍患者 120 例,随机分为针刺组、益生菌组和联合组,每组 40 例.3 组均于溶栓或血管内治疗后当日开始干预,针刺组以胃三针和肠三针为主进行针刺治疗,益生菌组口服 9 联益生菌,联合组采用针刺联合口服益生菌治疗.比较 3 组肠鸣音恢复时间、首次排气时间、首次排便时间、临床疗效和不良反应发生情况,观察 3 组治疗前后胃肠道功能障碍评分(gastrointestinal dysfunction score,GIDS)、进食-恶心-呕吐-查体-症状持续时间(intake,feeling nauseated,emesis,physical exam and duration of symptoms,I-FEED)评分以及血清胃泌素(gastrin,GAS)、促胃动素(motilin,MOT)、内毒素(endotoxin,ET)、二胺氧化酶(diamine oxidase,DAO)和 D-乳酸(D-lactate,LAC)水平的变化.结果 治疗后,3 组 GIDS 评分、I-FEED 评分以及血清 GAS、MOT、ET、DAO和 LAC 水平均优于同组治疗前(P＜0.05);3 组组间比较,差异均具有统计学意义(P＜0.05);组间两两比较,联合组均优于针刺组和益生菌组(P＜0.05).I-FEED 评分以及血清 GAS、MOT、ET、DAO和LAC 水平存在组别和时间的交互效应(P＜0.05).联合组肠鸣音恢复时间、首次排气时间和首次排便时间均短于其余两组(P＜0.05).联合组总有效率优于其余两组(P＜0.05).3组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 针刺联合多联益生菌治疗急性缺血性卒中合并胃肠功能障碍的临床疗效优于单一针刺或益生菌,可有效改善急性缺血性卒中患者的胃肠功能,维持肠道内环境.
Objective To observe the clinical efficacy of acupuncture plus multi-strain probiotics in treating acute ischemic stroke complicated with gastrointestinal dysfunction.Method One hundred and twenty patients with acute ischemic stroke complicated with gastrointestinal dysfunction were selected and randomized into an acupuncture group,a probiotics group,and a combined group,with 40 cases per group.The three groups all started intervention the day after thrombolysis and endovascular treatment;the acupuncture group received gastric three-needle and intestinal three-needle acupuncture as the main treatment,the probiotics group received a 9-strain compound probiotic via oral administration,and the combined group received acupuncture plus oral probiotics.The recovery time of bowel sounds,the time to the first flatus and the first defecation,clinical efficacy,and the incidence of adverse reactions were compared among the three groups.The three groups were observed the changes in the gastrointestinal dysfunction score(GIDS),the intake,feeling nauseated,emesis,physical exam and duration of symptoms(I-FEED)score,and the serum levels of gastrin(GAS),motilin(MOT),endotoxin(ET),diamine oxidase(DAO),and D-lactate(LAC)before and after treatment.Result After treatment,the GIDS,I-FEED score,and the levels of GAS,MOT,ET,DAO,and LAC improved in each group(P＜0.05);the inter-group comparisons showed statistical significance among the three groups(P＜0.05);pairwise comparisons showed that the combined group outperformed the acupuncture and probiotics groups(P＜0.05).The I-FEED score and serum levels of GAS,MOT,ET,DAO,and LAC demonstrated a group-time interactive effect(P＜0.05).The recovery time of bowel sounds and the time to first flatus and defecation were shorter in the combined group than in the other two groups(P＜0.05).The combined group had a higher total effective rate than the other two groups(P＜0.05).There were no significant differences in the adverse reaction rate among the three groups(P＞0.05).Conclusion Acupuncture combined with multi-strain probiotics can produce greater clinical efficacy in treating acute ischemic stroke complicated with gastrointestinal dysfunction compared to the sole use of acupuncture and probiotics;this method can effectively improve gastrointestinal function and maintain the intestinal internal environment in acute ischemic stroke patients.
方莉先;吕美霖;周思弟;张莹
四川宜宾市第四人民医院,宜宾 644000四川宜宾市第四人民医院,宜宾 644000四川宜宾市第四人民医院,宜宾 644000四川宜宾市第四人民医院,宜宾 644000
医药卫生
针刺疗法胃三针肠三针益生菌脑梗死中风并发症胃肠功能障碍
Acupuncture therapyStomach three-needle acupunctureIntestinal three-needle acupunctureProbioticsCerebral infarctionStrokeComplicationsGastrointestinal dysfunction
《上海针灸杂志》 2026 (8)
854-860,7
宜宾市科技局中医药研究项目(2023ZYY005)
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