Application Of Acupoint Hot Compress Of Traditional Chinese Medicine To Prevent Enteral Nutritional Intolerance In Severe Patients Based On Time Theory Of Traditional Chinese Medicine

Objective To observe the effects of acupoint hot compress of traditional Chinese medicine on the incidence of Enteral Feeding intolerance(EFI)and the rate of feeding up to standard in severe patients under the guidance of TCM time theory;It provides a new way of clinical nursing for patients with severe enteral nutrition.MethodsA total of one hundred and fourteen patients with enteral nutrition who met the inclusion criteria in the Intensive care unit(ICU)of the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2022 to December 2022 were selected as the study objects.Randomized number table method was used to divide the subjects into control group and experimental group to receive one-week enteral nutrition care,the control group received routine enteral nutrition care,and the experimental group was added to the control group under the guidance of traditional Chinese medicine time theory on the basis of Chinese medicine acupoint hot compress treatment.The target feeding standards of enteral nutrition for seven days were compared between the two groups.The incidence of gastrointestinal intolerance during feeding was compared between the two groups: abdominal distension,vomiting,diarrhea and gastric retention.Clinical nutrition monitoring indexes of the two groups were compared:Serum Albumin(ALB),Serum Prealbumin(P-ALB)and serum Total Protein(TP)levels were serum albumin(ALB),serum prealbumin(P-ALb)and serum total protein(TP)levels on DAY0 and DAY7;The changes of Acute Physiology and Chronic Health Evaluation(APACHE-Ⅱ score)were compared between the two groups.Results1.Target feeding standards of enteral nutrition in tow groups: Experimental group feeding standard rate is higher than the control group,two groups of patients feeding standard rate comparison difference has statistical significance(X2=5.549,P < 0.05),the experimental group first feeding standard required time is shorter,two groups of patients first feeding standard required time difference has statistical significance(t=-6.491,P < 0.05).2.Incidence of gastrointestinal intolerance during feeding in the two groups: Compared with the control group,the experimental group of patients with abdominal distension,vomiting,stomach retention incidence is lower,two groups of patients with abdominal distension(X 2=4.636,P < 0.05),vomiting(X 2=12.901,P < 0.05),gastric retention(X2=3.871,P < 0.05)the difference was statistically significant.However,there was no significant difference in the incidence of diarrhea between the two groups(X2=3.376,P > 0.05).3.Monitoring of clinical nutrition indexes of patients in the two groups: there was no difference in the three clinical nutrition indexes between the experimental group and the control group before intervention: Before intervention,there was no significant difference in serum total protein(t=-0.147,P > 0.05),serum albumin(t=-0.752,P >0.05)and serum prealbumin(t=-0.274,P > 0.05)between tow groups.The serum prealbumin of the control group was increased after intervention compared with before intervention,and the difference of serum prealbumin before and after intervention was statistically significant(t=-4.569,P < 0.05).However,there was no significant difference in serum total protein(t=1.065,P > 0.05)and serum albumin(t=0.281,P > 0.05)in control group before and after intervention.Serum total protein,serum albumin and serum prealbumin were increased in the experimental group after intervention compared with before intervention.Serum total protein(t=-2.489,P < 0.05)serum albumin(t=-5.642,P < 0.05)and serum prealbumin(t=-4.673,P < 0.05)were increased in the experimental group before and after intervention.The difference was statistically significant.Compared with the control group,the experimental group could effectively improve the serum total protein and serum albumin of the patients.The difference of clinical nutrition indexes in the two groups within seven days was compared.The results showed that the difference of serum total protein(t=2.674,P < 0.05)and serum albumin(t=3.998,P < 0.05)between the two groups was statistically significant.There was no significant difference in the difference of serum prealbumin between tow groups(t=0.436,P > 0.05).4.Comparison of APACHE-Ⅱ scores between the two groups: Before intervention,there was no significant difference in APACHE-Ⅱ scores between the control group and the experimental group(t=-0.038,P > 0.05).There was no change in APACHE-Ⅱ score of control group before and after intervention,and there was no significant difference in APACHE-Ⅱ before and after intervention(t=0.805,P > 0.05).The APACHE-Ⅱ score of the experimental group decreased after intervention compared with that before intervention,suggesting that the condition of the patients improved.The difference in APACHE-Ⅱ score of the experimental group before and after intervention was statistically significant(t=5.484,P < 0.05).ConclusionTCM acupoint hot compress under the guidance of TCM time theory can effectively improve the target feeding standard rate of patients with severe enteral nutrition and shorten the time to reach the target feeding quantity for the first time.Reduce the incidence of intestinal nutrition gastrointestinal intolerance symptoms,abdominal distension,vomiting,gastric retention;Increase serum total protein and serum albumin,improve nutritional status;Reducing APACHE-Ⅱ score was beneficial to the outcome of the disease.However,the incidence of diarrhea and the improvement of serum prealbumin were basically the same as the control group.