Objective

2

To observe the therapeutic effect of electroacupuncture (EA) in improving early enteral nutrition tolerance in patients with acute pancreatitis (AP) under the concept of accelerated rehabilitation

and to explore the related mechanism based on the changes in autonomic nerve characteristics.

Methods

2

A total of 42 patients with AP were randomized into an observation group (21 cases

1 case dropped out) and a control group (21 cases

1 case dropped out). The control group received standard basic treatment for AP. On the basis of the treatment in the control group

EA was applied in the observation group

bilateral Zusanli (ST36)

Yixian point (Extra)

Tianshu (ST25)

Neiguan (PC6) and Zhongwan (CV12) were selected as the main points

and the supplementary points were selected according to syndrome differentiation. Ipsilateral Zusanli (ST36) and Yixian point (Extra) were connected to EA

using discontinuous wave

in frequency of 2 Hz

30 min a time

once a day for 6 continuous days. The enteral nutrition tolerance score was observed before treatment and after 3 and 5 days of treatment; the visual analogue scale (VAS) score for abdominal pain was observed before treatment and after 3 days of treatment; the time of reaching the feeding goal and hospital stay was recorded; the levels of C-reactive protein (CRP) and amylase were measured before treatment and after 5 days of treatment; the heart rate variability (HRV) indexes (standard deviation of NN intervals [SDNN]

average standard deviation of NN intervals [SDANN]

root mean square of successive NN interval differences [rMSSD]

low frequency [LF] and high frequency [HF]

ratio of low frequency to high frequency [LF/HF]) were monitored in the two groups.

Results

2

After 3 and 5 days of treatment

the enteral nutrition tolerance scores were decreased compared with those before treatment in both groups (

P

<

0.01)

the reductions in the observation group were larger than those in the control group (

P

<

0.01). After 3 days of treatment

the VAS scores for abdominal pain were decreased compared with those before treatment in both groups (

P

<

0.01)

the reduction in the observation group was larger than that in the control group (

P

<

0.01). The time of reaching the feeding goal and hospital stay in the observation group was shorter than that in the control group (

P

<

0.05). After 5 days of treatment

the CRP and amylase levels were decreased compared with those before treatment in both groups (

P

<

0.01)

the reduction of CRP level in the observation group was larger than that in the control group (

P

<

0.01). In the observation group

SDNN

SDANN and LF/HF were lower than those in the control group (

P

<

0.05

P

<

0.01)

while rMSSD was higher than that in the control group (

P

<

0.01). SDNN

SDANN and LF/HF were positively correlated with the enteral nutrition tolerance scores after 3 and 5 days of treatment (

P

<

0.05)

while rMSSD was negatively correlated with the enteral nutrition tolerance scores after 3 and 5 days of treatment (

P

<

0.01).

Conclusion

2

Electroacupuncture can improve enteral nutrition tolerance in patients with AP by regulating autonomic nervous function

alleviating the inflammation

promoting accelerated recovery

and reducing the length of hospital stay.