不同频率TEAS结合腕带按压刺激内关穴防治腹腔镜胆囊切除术后恶心呕吐疗效观察  

The curative effect observation of different frequency of TEAS combined with wristband pressing on Neiguan(PC 6) for nausea and vomiting after laparoscopic cholecystectomy

作　　者：卢超[1,2] 杜俊英 方剑乔[1] 房军帆[1] LU Chao;DU Jun-ying;FANG Jian-qiao;FANG Jun-fan(Zhejiang Chinese Medical University,Hangzhou 310053,China;Zhejiang Cancer Hospital,Hangzhou 310022)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江省肿瘤医院,杭州310022

出　　处：《中国针灸》2019年第1期9-15,共7页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科技计划项目:2016ZA107;浙江省重点科技创新团队计划资助项目:2013TD15;浙江省大学生科技创新活动计划暨新苗人才计划项目:2016R410048

摘　　要：目的:比较不同频率的经皮穴位电刺激(TEAS)结合腕带按压刺激内关穴对腹腔镜胆囊切除术后恶心呕吐(PONV)的治疗效果,优化治疗PONV的TEAS频率选择。方法:将行腹腔镜胆囊切除术患者80例按随机数字表法随机分为术后常规护理组、2 Hz TEAS结合腕带按压组、100 Hz TEAS结合腕带按压组和2 Hz/100 Hz TEAS结合腕带按压组,每组20例(术后常规护理组脱落1例)。各组均行腹腔镜下胆囊切除术,在手术后均给予常规护理。术后常规护理组仅接受常规护理,余3组患者在术后常规护理基础上,在术后苏醒即刻分别采用2 Hz TEAS结合腕带按压、100 Hz TEAS结合腕带按压、2 Hz/100 Hz TEAS结合腕带按压刺激内关穴进行治疗,每次治疗30 min,共治疗4次。观察记录各组患者术后0~2 h、2~8 h、8~24 h及24~48 h各个时间段PONV发生率,并评估患者PONV严重程度及术后疼痛程度。结果:与术后常规护理组相比,2 Hz/100 Hz TEAS结合腕带按压组在术后4个时间段均能明显降低患者PONV发生率及严重程度(均P<0.05),2 Hz TEAS结合腕带按压组与100 Hz TEAS结合腕带按压组在术后2 h及2~8 h时间段能显著减轻患者PONV发生率与严重程度(均P<0.05),术后8 h、术后24 h时100 Hz TEAS结合腕带按压组与2 Hz/100 Hz TEAS结合腕带按压组均能减轻患者术后疼痛(均P<0.05)。结论:不同频率TEAS结合腕带按压刺激内关穴对腹腔镜胆囊切除术患者PONV都有一定的治疗效应,2 Hz/100 Hz TEAS结合腕带按压刺激内关穴对腹腔镜胆囊切除术患者PONV治疗效果更明显。2 Hz/100 Hz TEAS与100Hz TEAS结合腕带按压刺激内关穴对腹腔镜胆囊切除术患者均具有术后镇痛效应,2Hz/100Hz TEAS镇痛效应更佳。Objective To compare the effects of different frequency of transcutaneous electrical acupoint stimulation(TEAS) combined with wristband pressing on Neiguan(PC 6) for nausea and vomiting(PONV) after laparoscopic cholecystectomy, and optimize the TEAS frequency selection for treatment of PONV. Methods Eighty patients undergoing laparoscopic cholecystectomy were randomly divided into a postoperative routine care group, a 2 Hz TEAS combined with wristband pressing group(2 Hz TEAS group), a 100 Hz TEAS combined with combined with wristband pressing group(100 Hz TEAS group) and a 2 Hz/100 Hz TEAS wristband pressing group(2 Hz/100 Hz TEAS group), 20 cases in each group(1 patient dropped off in the postoperative routine care group). All the four groups underwent laparoscopic cholecystectomy, and routine nursing was given after the operation. In the postoperative routine nursing group,only routine nursing was received. In the other three groups, 2 Hz TEAS combined with wristband pressing, 100 Hz TEAS combined with wristband pressing, 2 Hz/100 Hz TEAS combined with wristband pressing to simulate Neiguan(PC 6) were treated on the basis of postoperative routine care after surgery. The treatment was given for 30 min each time for a total of 4 treatments. The incidence of PONV in each group was observed at 0-2 h, 2-8 h, 8-24 h and 24-48 h after operation, and the severity of PONV and postoperative pain were evaluated. Results Compared with the postoperativeroutine care group, the incidence and severity of PONV in the four time periods after surgery were significantly reduced in the 2 Hz/100 Hz TEAS group(all P<0.05), the incidence and severity of PONV in patients at 2 h and 2-8 h after surgery were significantly reduced in the 2 Hz TEAS group and the 100 Hz TEAS group(all P<0.05), the postoperative pain at 8 h and 24 h after surgery was alleviated in the 100 Hz TEAS group and the 2 Hz/100 Hz TEAS group(all P<0.05). Conclusion Different frequency of TEAS combined with wristband pressing to stimulating Neiguan(PC 6) have certain

关 键 词：术后恶心呕吐 腹腔镜胆囊切除术 经皮穴位电刺激 腕带按压 穴 内关 .频率 

分 类 号：R246.1[医药卫生—针灸推拿学]