[Shengqing Jiangzhuo acupuncture method for sepsis-associated gastrointestinal dysfunction: a randomized controlled...

To observe the efficacy and safety of Shengqing Jiangzhuo (raising the clear and lowering the turbid) acupuncture method for sepsis-associated gastrointestinal dysfunction, and to preliminarily explore its mechanism.

Ninety-six patients with sepsis-associated gastrointestinal dysfunction were randomly divided into an observation group (48 cases, 1 case dropped out) and a control group (48 cases, 5 cases dropped out). The observation group was treated with Shengqing Jiangzhuo acupuncture method on the basis of conventional western medical treatment, with acupoints including bilateral Zusanli (ST36), Neiguan (PC6), and Taichong (LR3), once daily for 7 days. The control group was treated with sham acupuncture on the basis of conventional western medical treatment, with corresponding non-acupoints, once daily for 7 days. Acute gastrointestinal injury ultrasonography score (AGIUS) was assessed before treatment and after 1, 3, and 7 days of treatment. Gastric residual volume (GRV) and incidence of feeding intolerance on days 1, 3, and 7 after initiation of enteral nutrition, daily caloric intake on days 1 and 3, and time required to reach target caloric intake were recorded.Peripheral blood inflammatory indexes [interleukin (IL)-10, IL-6, tumor necrosis factor-α (TNF-α), IL-17A, systemic immune- inflammation index (SII), white blood cell count (WBC), and procalcitonin (PCT)] and sequential organ failure assessment (SOFA) score were measured before and after treatment. The 28-day mortality and adverse events were recorded.

After 1 day of treatment, AGIUS in the observation group was lower than that before treatment (P<0.001). After 3 and 7 days of treatment, AGIUS in both groups were lower than those before treatment and after 1 day of treatment (P<0.001). After 7 days of treatment, AGIUS in the observation group was lower than that after 3 days of treatment (P<0.001). After 1, 3, and 7 days of treatment, AGIUS in the observation group were lower than those in the control group (P<0.001). On days 3 and 7 after initiation of enteral nutrition, GRV in both groups was lower than that on day 1 (P<0.001),and GRV on day 7 was lower than that on day 3 (P<0.001); GRV in the observation group at all time points was lower than that in the control group (P<0.001). On days 1 and 3 after initiation of enteral nutrition, the incidence of feeding intolerance in the observation group was lower than that in the control group (P<0.001, P<0.01), and daily caloric intake was higher than that in the control group (P<0.05, P<0.01). The time required to reach target caloric intake in the observation group was shorter than that in the control group (P<0.05). After treatment, SOFA scores in both groups were lower than those before treatment (P<0.001), and SOFA score in the observation group was lower than that in the control group (P<0.001). There was no statistically significant difference in 28-day mortality between the two groups (P>0.05).After treatment, the levels of IL-6, TNF-α, IL-17A, SII, WBC, and PCT in the observation group were lower than those before treatment (P<0.05), and IL-10 level was higher than that before treatment (P<0.05); in the control group, IL-6 and WBC levels were lower than those before treatment (P<0.05), and IL-10 level was higher than that before treatment(P<0.05). After treatment, except for IL-10, other inflammatory indexes in the observation group were lower than those in the control group (P<0.01, P<0.05). No adverse events related to acupuncture treatment or operation occurred in either group.

Shengqing Jiangzhuo acupuncture method can improve gastrointestinal function in patients with sepsis-associated gastrointestinal dysfunction, reduce the risk of early feeding intolerance. Its mechanism may be related to alleviating inflammatory response.