Therapeutic Effect Of Acupuncture And Bloodletting In Hand Twelve Wells On ICU Delirium

Objective To observe the clinical effect of acupuncture and bloodletting on patients with severe delirium.Using the scientific research method,the therapeutic effect of acupuncture and bleeding to delirium and whether there are any adverse reactions to clinical observation was evaluated objectively.In order to reduce the cost of hospitalization and improve the survival rate of patients.It will also provide evidence-based evidence for further exploration of the application of acupuncture in critical care medicine.Methods In June 2018 to March 2020 admitted during the period of Tianjin university of traditional Chinese medicine Wuqing hospital patients with severe medicine diagnosed with delirium,according to whether or not to use the hand twelve well point stab winding bloodletting divided into experimental group(hand twelve well point stab winding bloodletting+standardized treatment of western medicine)and control group(western medicine standardized treatment),the control group on the basis of the primary disease treatment using midazolam injection(Jiangsu Nhwa Pharmaceutical Co,Ltd,H10980025)approved by the conventional treatment,Experimental group of the control group on the basis of three edge needle(gushiad medical equipment cos,LTD.Drs-r-98 scores before and after treatment,cumulative delirium time,ICU treatment time,mechanical ventilation time,number of patients with only 1 delirium,outcome after treatment observation,and laboratory safety observation index examination.SPSS20.0 software was used for statistical analysis to observe whether there was a difference between the two groups and whether there was statistical significance.Results1.From June 2018 to March 2020,40 cases of delirium occurred in the department of critical care medicine of Wuqing hospital of traditional Chinese medicine affiliated to Tianjin university of traditional Chinese medicine and were randomly divided into the experimental group and the control group according to the method of random comparison table.The average age were 70.70±10.64 years,including 9 patients with pulmonary infection-related diseases,4 patients with cardiovascular diseases,4 patients with postoperative surgery,1 patient with digestive tract diseases,2 patients with shock,16 of the 19 patients had ventilators assisted breathing.In the conventional treatment group,there were 11 males and 9 females,with an average age of 67.60±13.69 years.There were 11 patients with pulmonary infection-related diseases,4 patients with cardiovascular diseases,and 5 patients after surgery.Each patient was evaluated once in the morning and once in the evening,and observed for at least 1 day,and at most 5 days.2.After statistics analysis,two groups of age,sex,weight,APACHE ? score all P > 0.05,there was no statistically significant difference.The ICU treatment time was compared at 5 days after observation and treatment,and the difference was not statistically significant.The comparison of mechanical ventilation time between the two groups was P> 0.05,and the difference was not statistically significant.There was no significant difference in delirium duration between the two groups(P>0.05).The comparison of delirium severity score of drs-r-98 between the two groups before and after treatment showed that the difference was statistically significant(P< 0.05),indicating that the delirium severity could be improved after treatment.Before and after treatment,there was no significant difference between the experimental group and the control group(P>0.05).According to the DRS efficacy analysis calculated by nimodipine,the effective rate of the experimental group was 57.89%,and that of the control group was 75%.Comparison between the two groups showed no statistically significant difference at P> 0.05,indicating that there was no difference in the efficacy rate of the two groups.After treatment,the outcome of the two groups was observed.Among them,there were 7cases of 37% in the experimental group with only 1 delirium,and 2 cases in the control group(9%).The comparison between the two groups was P< 0.05,indicating that the experimental group was superior to the control group.There were 5 cases (26%)in the experimental group and 13 cases(59%)in the control group(P< 0.05),and the difference was statistically significant.There were 2 cases(10%)of subdelirium in the test group and 2 cases(9%)in the control group when they were transferred out of the department,and the difference was not statistically significant(P>0.05).There were 3 patients(16%)in the experimental group and 3 patients(14%)in the control group after the observation period.No significant difference was found in P> 0.05.After the treatment,there were 2 patients(11%)in the experimental group and 2 patients(10%)in the control group with coma,with no statistically significant difference(P> 0.05).3.Comparison of safety indexes: there was no statistically significant difference in safety indexes of liver function(AST,ALT),renal function(Cr,BUN)(P>0.05)between the experimental group and the control group before and after treatment.During the observation period,2 patients(10%)in the control group had somnolence adverse reactions,and their symptoms improved after reducing the drug dose.No somnolence occurred in the experimental group,and no other adverse reactions occurred in the two groups.Conclusion It is worthy of clinical promotion to reduce the occurrence of delirium and the incidence of delirium in critically ill patients.The DRS score was reduced in both the acupuncture and bleeding group and the conventional treatment group,and the severity of delirium was improved.Acupuncture and bloodletting of the hand twelve Wells may alleviate the side effects of drugs used to treat delirium.There was no significant effect on the cumulative delirium time,total mechanical ventilation time,ICU admission time and outcome of curative effect.