Electroacupuncture in Treatment of Acute Gastrointestinal Injury in Patients with Severe Traumatic Brain Injury: A Multicenter Randomized Controlled Trial.

Autor: Xing X; Department of ICU, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, China., Jiang RL; Department of ICU, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, China. jiangronglin@126.com., Lei S; Department of ICU, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, China., Zhi YH; Department of ICU, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, China., Zhu MF; Department of ICU, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, China., Huang LQ; Department of ICU, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, China., Hu MH; Department of ICU, Tongde Hospital of Zhejiang, Tongde, Zhejiang Province, 310000, China., Lu J; Department of ICU, Xinhua Hospital of Zhejiang, Hangzhou, 310000, China., Fang K; Department of ICU, Zhejiang Integrated Traditional Chinese, and Western Medicine Hospital, Hangzhou, 310000, China., Wang QY; Department of ICU, Hangzhou Hospital of Traditional Chinese Medical, Hangzhou, 310000, China.
Jazyk: angličtina
Zdroj: Chinese journal of integrative medicine [Chin J Integr Med] 2023 Aug; Vol. 29 (8), pp. 721-729. Date of Electronic Publication: 2022 May 04.
DOI: 10.1007/s11655-022-3670-0
Abstrakt: Objective: To evaluate whether electroacupuncture (EA) would improve gastrointestinal function and clinical prognosis in patients with severe traumatic brain injury (TBI) complicocted by acute gastrointestinal injury (AGI).
Methods: This multicenter, single-blind trial included patients with TBI and AGI admitted to 5 Chinese hospitals from September 2018 to December 2019. A total of 500 patients were randomized to the control or acupuncture groups using a random number table, 250 cases in each group. Patients in the control group received conventional treatment, including mannitol, nutritional support, epilepsy and infection prevention, and maintenance of water, electrolytes, and acid-base balance. While patients in the acupuncture group received EA intervention at bilateral Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Tianshu (ST 25), and Zhongwan (RN 12) acupoints in addition to the conventional treatment, 30 min per time, twice daily, for 7 d. The primary endpoint was 28-d mortality. The secondary endpoints were serum levels of D-lactic acid (D-lac), diamine oxidase (DAO), lipopolysaccharide (LPS), motilin (MTL) and gastrin (GAS), intra-abdominal pressure (IAP), bowel sounds, abdominal circumference, AGI grade, scores of gastrointestinal failure (GIF), Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation (APACHE II), Sequential Organ Failure Assessment (SOFA), and Multiple Organ Dysfunction Syndrome (MODS), mechanical ventilation time, intense care unit (ICU) stay, and the incidence of hospital-acquired pneumonia.
Results: The 28-d mortality in the acupuncture group was lower than that in the control group (22.80% vs. 33.20%, P<0.05). Compared with the control group, the acupuncture group at 7 d showed lower GIF, APACHE II, SOFA, MODS scores, D-lac, DAO, LPS, IAP, and abdominal circumference and higher GCS score, MTL, GAS, and bowel sound frequency (all P<0.05). In addition, the above indices showed simillar changes at 7 d compared with days 1 and 3 (all P<0.05) in the EA group.
Conclusion: Early EA can improve gastrointestinal function and clinical prognosis in patients with severe TBI complicated by AGI. (Registration No. ChiCTR2000032276).
(© 2022. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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