Effect Of Midnight-midday Ebb Flow Combined With Hot Ironing Of Evodia Officinalis On Postoperative Acute Gastrointestinal Injury In ICU Patients With Severe Craniocerebral Injury

Objective:The midnight-midday ebb flow combined with Evodia rutaecarpa hot iron was used for postoperative patients with severe craniocerebral injury in ICU to observe the effect of this therapy on secondary acute gastrointestinal injury(grade I or II)in patients with severe craniocerebral injury in ICU,so as to provide a scientific and effective method for promoting the recovery of secondary acute gastrointestinal function injury in patients with severe craniocerebral injury in ICU and reducing complications.Methods:By adopt a randomized controlled study method.A total of 66 patients who were admitted to the ICU of the Second Affiliated Hospital of Kunming Medical University from January 2022 to June 2022 and underwent severe craniocerebral injury surgery were divided into the control group(n=33)and the experimental group(n=33)according to the random number table.Control group: On the basis of routine treatment and nursing care,simple hot iron was applied to the abdomen.Experimental group: On the basis of routine treatment and care,Evodia rutaecarpa was given hot iron on the abdomen.Intervention method: Starting from the first day after surgery,Shenque was hot-ironed at 09:00,11:00,and 15:00,which were determined by Ziwu Liuzhu Nazhi branch method.The temperature was controlled within 40～50°C,30 min per time,and the intervention was continued for three days.The general baseline data of the two groups were compared as well as borborygmus,intra-abdominal pressure,first defecation time,gastrointestinal dysfunction score,APACHE II score,MAP and other indicators before and after treatment.SPSS25.0 statistical software was used for statistical analysis.Results:A total of 66 patients with acute gastrointestinal injury(grade Ⅰ or II)secondary to severe craniocerebral injury were included in the study,33 in the experimental group and 33 in the control group.There were no cases of dropping out and withdrawal.1.Comparison of borborygmus: The number of borygmus in patients between the two groups increased after treatment,and the difference was statistically significant(P<0.001);The number of borborygmus in the experimental group was greater than that in the control group(P<0.05).2.Comparison of intra-abdominal pressure: The intra-abdominal pressure in the two groups of patients decreased after treatment,and the difference was statistically significant(P<0.001);The intra-abdominal pressure in the experimental group was lower than that in the control group(P<0.05).3.Gastrointestinal dysfunction score: After treatment,the gastrointestinal dysfunction score of patients in the two groups was decreased,and the difference was statistically significant(P<0.001);The scores of gastrointestinal dysfunction in the experimental group were lower than those in the control group(P<0.05).4.First defecation time: after treatment,the defecation time in the experimental group was shorter than that in the control group,and the defecation rate in the experimental group was higher than that in the control group(P<0.05).5.Comparison of disease severity and prognosis between the two groups: There was no change in the APACHE II score of the two groups after treatment,and the difference was not statistically significant(P>0.05);there was no difference in the APACHE II score between the two groups(P>0.05).6.Comparison of MAP: There was no change in MAP between the two groups after treatment,and the difference was not statistically significant(P>0.05).There was no difference in MAP between the two groups(P>0.05).7.There was no adverse reaction related to hot ironing of Evodia during the whole study.Conclusions:1.The midnight-midday ebb flow combined with Evodia rutaecarpa hot iron can effectively promote the recovery of secondary acute gastrointestinal dysfunction(grade I or II)in patients with severe craniocerebral injury in ICU.2.The midnight-midday ebb flow combined with Evodia rutaecarpa hot iron could not reduce the APACHE II score of patients with acute gastrointestinal function impairment secondary to severe craniocerebral injury surgery in ICU,and the effect of hot ironing on MAP was not significant.3.External therapy of traditional Chinese medicine with hot iron on the abdomen is safe for patients with severe craniocerebral injury in ICU after operation.