Effect of the combination of he-sea and front-mu points on enteral nutrition feeding intolerance in critical illness patients. / åˆå‹Ÿé ç©´æ²»ç–—å±é‡ç—‡æ‚£è€ è‚ å† è¥å »å–‚å »ä¸è€å—çš„ç–—æ•ˆè§‚å¯Ÿ.

OBJECTIVES: To explore the effects of the combination of he-sea and front-mu points on the feeding compliance rate, the intra-abdominal pressure, the enteral nutrition tolerance score, the score of acute physiological and chronic health evaluation (APACHE)-Ⅱ and gastrointestinal function impairment grade in the patients with enteral nutrition feeding intolerance (ENFI) of critical illness and evaluate clinical effect on ENFI after acupuncture at the he-sea and front-mu points. METHODS: Seventy patients of ENFI were randomized into a control group and an observation group, 35 cases in each one. In the control group, the patients were treated with routine regimen combined with intestinal nutrition support. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Shangwan (CV13), Zhongwan (CV12), Xiawan (CV10), Qihai (CV6) and Guanyuan (CV4), as well as bila-teral Neiguan (PC6), Zusanli (ST36), Xiajuxu (ST39), Shangjuxu (ST37), Tianshu (ST25) and Daheng (SP15). Of those acupoints, ST25 and SP15 on the same side were attached to one pair of electrodes (20 Hz/100 Hz). Acupuncture was delivered once daily, 30 min each time and for consecutive 7 days. During treatment, the numbers of the cases up to the feeding standard were observed everyday to calculate the feeding compliance rate. The score of enteral nutrition tolerance, the intra-abdominal pressure, the score of APACHE-Ⅱ and the level of acute gastriointestinal injury(AGI) grading were recorded. RESULTS: After treatment, the enteral feeding compliance rate was increased in comparison with that before treatment in the two groups, and the rate in the observation group was higher than that of the control group (P<0.05) except that on the 2nd day. The score of the enteral nutrition tolerance, the intra-abdominal pressure, the score of APACHE-Ⅱ and the level of AGI were all reduced (P<0.05, P<0.01) when compared with those before treatment in the two groups, and these indicators in the observation group were lower (P<0.05) than those of the control group. CONCLUSIONS: Acupuncture at the he-sea and front-mu points relieves the conditions of ENFI, improves the feeding and the recovery of gastrointestinal function, and benefits the prognosis through increasing the amount of enteral nutrition in ENFI patients.

[Prevention of hospital-acquired pneumonia with Yupingfeng Powder in patients with acute cerebral vascular diseases: a randomized controlled trial].

BACKGROUND: An increase in the incidence rate of hospital-acquired pneumonia (HAP) has a direct influence on prognosis and survival of patients with acute cerebral vascular diseases (ACVD), and how to prevent HAP is a growing concern to clinicians. OBJECTIVE: To study the efficacy of Yupingfeng Powder, a compound traditional Chinese herbal medicine, in preventing HAP in patients with ACVD. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: Sixty ACVD patients with lung qi deficiency syndrome without concurrent infections were randomly divided into prevention group (28 cases) and control group (32 cases). The 60 cases were all from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Tough measures were taken to prevent cross-infection based on treatment of the primary diseases, well nutrition and support therapy. Yupingfeng Powder was used in the prevention group to prevent HAP. The patients were treated for 10 days. MAIN OUTCOME MEASURES: The clinical symptoms, physical signs, body temperature, and chest X-ray were observed. The changes of blood immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM) and interleukin-6 (IL-6) were detected before and after treatment. RESULTS: The total response rate in the prevention group was higher than that in the control group (P<0.05), and the total response rates were 78.57% (22/28) and 31.25% (10/32) respectively. The incidence rate of HAP in the prevention group was lower than that in the control group. There were no significant differences in white blood cell count, neutrophilic granulocyte count, and the levels of IgA, IgG, IgM and IL-6 between the two groups before treatment. The white blood cell count and neutrophilic granulocyte count in the control group increased after treatment, and there was a significant difference between the two groups (P<0.05). There was no significant difference in IgA level in the two groups after treatment, and the IgM levels in the two groups were higher than those before treatment (P<0.05), however there was no significant difference in IgM level between the two groups. In the prevention group, there were significant differences in values of IgG and IL-6 between before and after treatment (P<0.01), and after treatment there were differences in values of IgG and IL-6 between the two groups (P<0.05). CONCLUSION: Yupingfeng Powder has a good clinical effect in prevention of HAP in patients with ACVD, and it can improve the immunological function and relieve the lung qi deficiency symptoms. So the prevention effect of Yupingfeng Powder on HAP is worth being further investigated.

[Diagnostic value of assay of brain natriuretic peptide in patients with sepsis of blood-stasis syndrome].

OBJECTIVE: To explore the diagnostic value of brain natriuretic peptide (BNP) level in patients with sepsis of blood-stasis syndrome. METHODS: The prospective method of clinical diagnostic test and evaluation principles of diagnostic test were applied. One hundred and seventy-four patients with sepsis were divided into two groups: blood-stasis syndrome group and non blood-stasis syndrome group. The levels of serum BNP in two groups were detected. RESULTS: The level of BNP in sepsis patients was related to blood-stasis syndrome (P<0.01). BNP cut-off level was 150 ng/L, sensitivity was 85.3%, specificity was 81%, the maximum value of Youden index was 0.663, and the area under the receiver operating characteristic curve (ROC) value was (0.886+/-0.025). CONCLUSION: BNP can be used as an objective index of blood-stasis syndrome diagnosis for sepsis, and BNP with boundary value of 150 ng/L is an optimal biological index.