肛肠手术行穴位经皮刺激复合药物麻醉的抗应激及镇痛效应研究  

Research on Anti-stress Effect and Analgesic Effect of Transcutaneous Acupoint Stimulation Combined with Drug Anesthesia during Anorectal Operation

作　　者：林玉芳[1,2] 李寅[2] 万钰茜 陈梁[1,2] 杨巍[3] 马文[2] 沈卫东[2] 

机构地区：[1]上海中医药大学研究生院,上海201203 [2]上海中医药大学附属曙光医院针灸科,上海201203 [3]上海中医药大学附属曙光医院肛肠科,上海201203

出　　处：《上海中医药大学学报》2015年第4期30-33,共4页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科研计划资助项目(12401903204)

摘　　要：目的:探讨肛肠手术行穴位经皮刺激复合药物麻醉的抗应激效应及术后镇痛效应。方法:纳入70例肛肠疾病行肛肠手术的患者,随机分为治疗组和对照组,每组35例。治疗组采用穴位经皮刺激复合药物麻醉,对照组采用常规药物麻醉。术后采用疼痛语言评价量表(VRS)评定患者的疼痛程度;手术前后收集患者的唾液样本,检测患者的唾液皮质醇和α淀粉酶水平。结果:术后2 h,治疗组患者的疼痛评分明显低于对照组(P<0.05);术后24 h,两组患者的疼痛评分比较,差异无统计学意义(P>0.05)。手术后,对照组患者的唾液皮质醇水平有所升高(P<0.05),且两组患者的唾液皮质醇手术前后差值比较,差异有统计学意义(P<0.05)。手术前后两组患者的唾液α淀粉酶水平的组内及组间比较,差异均无统计学意义(P>0.05)。结论:穴位经皮刺激复合药物麻醉较常规药物麻醉可缓解肛肠手术患者的术后疼痛,降低患者的应激水平。Objective： To explore the anti-stress effect and post-operative analgesic effect of transcutaneous acupoint stimulation combined with drug anesthesia during anorectal operation. Methods： A total of 70 cases of patients with anorectal diseases undergoing anorcctal surgery were randomly divided into treatment group and control group with 35 cases in each group. The patients in the treatment group were treated with transcutaneous acupoint stimulation combined with drug anesthesia and the patients in the control group were treated with conventional drug anesthesia. The pain degree of patients after operation was assessed by pain language assessment scale （VRS） ; the saliva samples were collected before and after surgery and the levels of salivary cortisol and a amylase were detected. Results： Two hours after surgery, the pain scores of the treatment group were significantly lower than those of the control group （ P 〈 0.05 ） ; there was no statistical difference between two groups on the pain scores 24 hours after surgery （ P 〉 0.05 ）. After surgery, the level of saliva cortisol of the control group was increased （ P 〈0.05 ）, and there was a statistical difference between the two groups on the D-value of the level of saliva cortisol between before and after surgery （ P 〈 0.05 ）. There were no statistical differences on the level of saliva α amylase between the two groups before and after surgery （ P 〉 0.05 ）. Conclusion ： Transcutaneous acupoint stimulation combined with drug anesthesia during anorectal operation can relieve the post-operative pain and reduce the stress level for patients with anorectal disease.

关 键 词：穴位经皮刺激 应激 镇痛 肛肠手术 

分 类 号：R246.2[医药卫生—针灸推拿学]