经皮穴位电刺激对严重烧伤患者的心肌细胞保护作用  

The myocardial cell protection research of Transcutaneous acupoint electrical stimulation in patients with severe burns

作　　者：张立贤[1] 彭亮[1] 陈伟业 王琳[1] 王爱群[1] 张志[1] 曹阳[1] 

机构地区：[1]广州市暨南大学医学院第四附属医院、广州市红十字会医院麻醉科,510220 [2]广州市天河区妇幼保健院麻醉科,510620

出　　处：《实用医学杂志》2016年第9期1428-1431,共4页The Journal of Practical Medicine

基　　金：广州市中医药科技项目(编号:20122A011014)

摘　　要：目的：探讨经皮穴位电刺激（TEAS）对严重烧伤患者早期的心肌保护作用。方法：选择烧伤患者60例,随机分为经皮穴位电刺激组（T组）和对照组（C组）。C组按烧伤常规治疗,T组在烧伤常规治疗基础上,采用TEAS连续治疗4-5 d。观察指标：分析第1、3、5天的心率变异性（HRV）;取患者入院后1（T1）、12（T2）、24（T3）、48（T4）、72 h（T5）的静脉血检测血浆肌钙蛋白T（c Tn T）、血浆肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平。结果 ：两组患者在T2时,c Tn T达到峰值,其后逐渐下降,各时点与T1比较差异有统计学意义（P〈0.05）;LF、HF在烧伤后持续上升,第3、5天时与第1天比较差异有统计学意义（P〈0.05）,LF/HF则逐渐下降;TNF-α、IL-6在烧伤后持续升高,TNF-α在T5时最高,IL-6在T4达到峰值,各时点与T1比较差异有统计学意义（P〈0.05）。结论：TEAS可调控烧伤患者的炎症介质释放、减轻全身炎症反应和应激反应,调节植物神经的均衡性而改善心肌血流,从而在烧伤早期发挥心肌保护作用。Objective To explore the myocardial protective effect of TEAS in severely burned patients.Methods Sixty burned cases were randomly assigned into the Transcutaneous acupoint stimulation group（T group） and the control group（group C）. The group C received the routine treatment, while group T received burn routine therapy of TEAS for 4 - 5 days. Observation indexes ： heart rate variability（HRV） of 1, 3, 5days; The venous blood serum troponin T（c Tn T）, plasma tumor necrosis factor alpha（TNF-α） and interleukin-6（IL-6） level were detected after patients admitted to hospital at T1（1 h）, T2（12 h）, T3（24 h）, T4（48 h）, T5（72 h）. Results The c Tn T reached peak at T2 in the two groups, then gradually declined. There were significant differences between each point and T1（P〈0.05）; LF, HF rose after burn. There were significant differences between 3 d, 5 d and 1 d（P〈0.05） about the LF and HF; LF / HF decreased. TNF-α and IL-6continued to rise after burn, the TNF-a was highest at T5,while IL-6 reached peak at T4. There were significant differences between the group C and group T above on the indexes at T5（P〈0.05）. Conclusions TEAS could reduce systemic inflammatory response and stress reaction, As well it could adjust autonomic nervous system balance and improve myocardial blood flow, thus produce myocardial protection in burn patients.

关 键 词：烧伤 经皮穴位电刺激 心率变异性 肌钙蛋白T 

分 类 号：R644[医药卫生—外科学]