电针对急性胰腺炎患者早期肠内营养耐受性及自主神经活动的影响

陈栋; 李迎欣; 朱世鹏; 原萌谦; 耿艳霞; 张璐瑶; 连晓阳; 龚冠闻

doi:10.13703/j.0255-2930.20250407-k0004

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电针对急性胰腺炎患者早期肠内营养耐受性及自主神经活动的影响

临床研究 | 更新时间：2025-11-20

- 电针对急性胰腺炎患者早期肠内营养耐受性及自主神经活动的影响
- Effects of electroacupuncture on early enteral nutrition tolerance and autonomic nerve activity in patients with acute pancreatitis
- 中国针灸 2025年45卷第11期页码：1549-1555
- 作者机构：
  
  南京中医药大学附属医院针灸康复科，江苏南京　210029
  南京中医药大学第一临床医学院
  南京中医药大学针灸推拿学院·养生康复学院
  南京中医药大学附属医院重症医学科，江苏南京　210029
  南京中医药大学医学院
  南京中医药大学附属医院普外科，江苏南京　210029
- 作者简介：
  
  ✉龚冠闻，主任医师。E-mail：love_ggw2@163.com
- 基金信息：
  
  国家自然科学基金面上项目(82474636);江苏省中医药管理局项目(ZT202108);江苏省中医院研究者发起项目(YJZ202472);南京健康广场健康产业开放课题项目(NJJKGC202203)
- DOI：10.13703/j.0255-2930.20250407-k0004
  中图分类号：
- 收稿：2025-04-07，
  
  网络首发：2025-06-24，
  
  纸质出版：2025-11-12
- 稿件说明：
移动端阅览
陈栋, 李迎欣, 朱世鹏, 等. 电针对急性胰腺炎患者早期肠内营养耐受性及自主神经活动的影响[J]. 中国针灸, 2025,45(11):1549-1555.

CHEN Dong, LI Yingxin, ZHU Shipeng, et al. Effects of electroacupuncture on early enteral nutrition tolerance and autonomic nerve activity in patients with acute pancreatitis[J]. Chinese Acupuncture & Moxibustion, 2025, 45(11): 1549-1555.
陈栋, 李迎欣, 朱世鹏, 等. 电针对急性胰腺炎患者早期肠内营养耐受性及自主神经活动的影响[J]. 中国针灸, 2025,45(11):1549-1555. DOI： 10.13703/j.0255-2930.20250407-k0004.

CHEN Dong, LI Yingxin, ZHU Shipeng, et al. Effects of electroacupuncture on early enteral nutrition tolerance and autonomic nerve activity in patients with acute pancreatitis[J]. Chinese Acupuncture & Moxibustion, 2025, 45(11): 1549-1555. DOI： 10.13703/j.0255-2930.20250407-k0004.

摘要

目的：

观察加速康复理念下电针改善急性胰腺炎（AP）患者早期肠内营养耐受性的疗效，并基于自主神经特征变化探索相关机制。

方法：

将42例AP患者随机分为观察组（21例，脱落1例）和对照组（21例，脱落1例）。对照组予AP规范基础治疗；观察组在对照组基础上加用电针干预，穴取双侧足三里、胰腺穴、天枢、内关和中脘，并配合辨证选穴，同侧足三里及胰腺穴为一组连接电针仪，选择断续波，频率2 Hz，每次30 min，每日1次，连续6 d。分别于治疗前及治疗3、5 d后观察两组患者肠内营养耐受性评分；于治疗前和治疗3 d后观察两组患者腹痛视觉模拟量表（VAS）评分；记录两组患者达到喂养目标时间和住院天数；于治疗前和治疗5 d后检测两组患者C反应蛋白（CRP）和淀粉酶水平；监测两组患者心率变异性（HRV）指标[窦性心搏NN间期标准差（SDNN）及标准差平均值（SDANN）、连续差值的均方根（rMSSD）、低频（LF）、高频（HF）、低频与高频比（LF/HF）]。

结果：

治疗3、5 d后，两组患者肠内营养耐受性评分较治疗前降低（

0.01），且观察组降低幅度大于对照组（

0.01）。治疗3 d后，两组患者腹痛VAS评分较治疗前降低（

0.01），且观察组降低幅度大于对照组（

0.01）。观察组患者达到喂养目标时间和住院天数短于对照组（

0.05）。治疗5 d后，两组患者CRP、淀粉酶水平较治疗前降低（

0.01）；观察组患者CRP水平降低幅度大于对照组（

0.01）。观察组患者SDNN、SDANN和LF/HF低于对照组（

0.05，

0.01），rMSSD高于对照组（

0.01）。SDNN、SDANN、LF/HF与治疗3、5 d后肠内营养耐受评分均呈正相关关系（

0.05），rMSSD与治疗3、5 d后肠内营养耐受性评分呈负相关关系（

0.01）。

结论：

电针可通过调节自主神经功能改善AP患者肠内营养耐受性，减轻炎性反应状态，促进患者康复，减少住院时间。

Abstract

Objective

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

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

After 3 and 5 days of treatment

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

0.01)

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

0.01). After 3 days of treatment

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

0.01)

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

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

0.05). After 5 days of treatment

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

0.01)

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

0.01). In the observation group

SDNN

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

0.05

0.01)

while rMSSD was higher than that in the control group (

0.01). SDNN

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

0.05)

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

0.01).

Conclusion

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.

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