Objective:

2

To evaluate whether electroacupuncture (EA) would improve gastrointestinal function and clinical prognosis in patients with severe traumatic brain injury (TBI) complicocted by acute gastrointestinal injury (AGI).

Methods:

2

This multicenter

single-blind trial included patients with TBI and AGI admitted to 5 Chinese hospitals from September 2018 to December 2019. A total of 500 patients were randomized to the control or acupuncture groups using a random number table

250 cases in each group. Patients in the control group received conventional treatment

including mannitol

nutritional support

epilepsy and infection prevention

and maintenance of water

electrolytes

and acid-base balance. While patients in the acupuncture group received EA intervention at bilateral Zusanli (ST 36)

Shangjuxu (ST 37)

Xiajuxu (ST 39)

Tianshu (ST 25)

and Zhongwan (RN 12) acupoints in addition to the conventional treatment

30 min per time

twice daily

for 7 d. The primary endpoint was 28-d mortality. The secondary endpoints were serum levels of D-lactic acid (D-lac)

diamine oxidase (DAO)

lipopolysaccharide (LPS)

motilin (MTL) and gastrin (GAS)

intra-abdominal pressure (IAP)

bowel sounds

abdominal circumference

AGI grade

scores of gastrointestinal failure (GIF)

Glasgow Coma Scale (GCS)

Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ)

Sequential Organ Failure Assessment (SOFA)

and Multiple Organ Dysfunction Syndrome (MODS)

mechanical ventilation time

intense care unit (ICU) stay

and the incidence of hospital-acquired pneumonia.

Results:

2

The 28-d mortality in the acupuncture group was lower than that in the control group (22.80%

vs

. 33.20%

P

<

0.05). Compared with the control group

the acupuncture group at 7 d showed lower GIF

APACHE Ⅱ

SOFA

MODS scores

D-lac

DAO

LPS

IAP

and abdominal circumference and higher GCS score

MTL

GAS

and bowel sound frequency (all

P

<

0.05). In addition

the above indices showed simillar changes at 7 d compared with days 1 and 3 in the EA group (all

P

<

0.05).

Conclusion:

2

Early EA can improve gastrointestinal function and clinical prognosis in patients with severe TBI complicated by AGI. (Registration No. ChiCTR2000032276)