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| Effects of acupuncture and moxibustion on enteral nutrition aspiration, gas- trointestinal function， and inflammatory indexes in critically ill patients |
| KONG Wenwei1 ZHUGE Lingli1 ZHANG Yibing2 |
1.Department of Critical Care Medicine, Wenzhou Central Hospital, Zhejiang Province, Wenzhou 325000, China;
2.Department of Gastroenterology, Wenzhou Central Hospital, Zhejiang Province, Wenzhou 325000, China |
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Abstract Objective To investigate the effects of acupuncture and moxibustion on enteral nutrition (EN) aspiration, gastrointestinal function, and inflammatory indexes in critically ill patients. Methods A total of 106 critically ill patients from the Department of Critical Care Medicine, Wenzhou Central Hospital of Zhejiang Province from January 2021 to December 2022 were selected and they were divided into acupuncture and moxibustion group and control group according to random number table method, with 53 cases in each group. The control group was given EN support within 24 to 48 h after admission. If there was feeding intolerance, Metoclopramide could be given intramural injection, 10 mg/time, twice a day, for 24 to 48 h. The acupuncture and moxibustion group was treated on the basis of the control group, and moxibustion was selected at zúsānlǐ and zhōngwǎn, hanging moxibustion, twice a day, 15 min/times; acupuncture was selected at two sides of zúsānlǐ, sānyīnjiāo, nèiguān, zhōngwǎn, shàngjùxū, xiàjùxū, tiānshū, and qìhǎi, warming needle moxibustion was selected at zúsānlǐ, or zhōngwǎn. Puncture the acupoint directly and leave the needle for 30 min after arrival of qi, once a day. Both groups were treated for one week. The acute gastrointestinal injury (AGI) grade, inflammatory indexes (interleukin [IL] -6, IL-1β, tumor necrosis factor-α [TNF-α]), and nutritional indexes (albumin [Alb], prealbumin [PA], hemoglobin [Hb]) of the two groups were compared before and after intervention. EN complications and Metoclopramide dosage were analyzed. Results After one week of intervention, AGI grading in both groups was lower than that before intervention, and that in acupuncture and moxibustion group was lower than that in control group, the differences were statistically significant (P＜0.05). After one week of intervention, serum IL-6, IL-1β, and TNF-α levels in two groups were lower than those before intervention, and those in the acupuncture group were lower than those in the control group, the differences were statistically significant (P＜0.05). After one week of intervention, serum Alb, PA, and Hb levels in two groups were higher than those before intervention, and those in the acupuncture group was higher than those in the control group, the differences were statistically significant (P＜0.05). The incidences of aspiration, diarrhea, and abdominal distension in acupuncture and moxibustion group were lower than that in control group, and the differences were statistically significant (P＜0.05). The dosage of Metoclopramide in acupuncture and moxibustion group was lower than that in control group, and the difference was highly statistically significant (P＜0.01). Conclusion Acupuncture and moxibustion for EN support in critically ill patients can significantly improve gastrointestinal function and nutritional status, reduce inflammatory response, and reduce complications such as aspiration.
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