针刺对乳腺癌患者围手术期镇痛作用及免疫功能的影响  

Research of acupuncture for the perioperative analgesia and immune function of the breast cancer patients

作　　者：陈梦 雷华娟[1] 郑松[1] 王佳怡 

机构地区：[1]湖南中医药大学第一附属医院麻醉科,长沙410007

出　　处：《国际中医中药杂志》2018年第1期22-25,共4页International Journal of Traditional Chinese Medicine

基　　金：湖南省科技计划项同（2015JC3071）

摘　　要：目的 观察针刺对乳腺癌患者围手术期的镇痛作用及对免疫功能的影响。方法 将符合入选标准的40例乳腺癌根治术患者采用随机数字表法分为2组，每组20例。针药复合组采用药物靶控输注麻醉结合针灸止痛，对照组采用单纯药物靶控输注麻醉止痛。分别于术后2、6、12、24、48 h采用VAS量表评价患者疼痛程度；分别于麻醉前30 min，手术开始后2 h，术后1、2、5 d检测外周血T淋巴细胞亚群（CD3＋、CD4＋、CD8＋）及NK细胞（CD16＋CD56＋）百分比、CD4＋/CD8＋比值。结果 针药复合组术后2 h[（2.3±1.1）分比（3.8±1.1）分，t＝2.378]、6 h[（2.6±1.2）分比（5.6±1.4）分，t＝3.289]、12 h[（3.5±1.5）分比（5.0±1.3）分，t＝2.040]VAS评分低于对照组（P＜0.05）；术后1 d，针药复合组CD3＋[（52.35±4.20）%比（48.01±4.42）%，t＝2.127]、CD4＋[（27.81±2.72）%比（24.96±2.60）%，t＝2.250]、CD4＋/CD8＋[（1.12±0.15）比（1.01±0.13），t＝2.136]均高于对照组（P＜0.05）；针药复合组术后2 h CD16＋CD56＋[（14.79±2.04）%比（13.58±1.50）%，t＝2.852]、1 d[（14.43±2.27）%比（13.11±1.82）%，t＝2.933]高于对照组（P＜0.05）。结论 针灸对全麻下乳腺癌根治术患者镇痛效果确切，对术后T淋巴细胞亚群和NK细胞有保护作用，可改善患者的免疫功能。Objective To research of acupuncture for the perioperative analgesia and immune function of the breast cancer patients. Methods A total of 40 breast cancer patients who were carried out the radical operation was randomly （random number table method） divided into acupuncture combined drugs group and control group in our hospital during from 2015.1 to 2016.12. The patients in acupuncture combined drugs group was carried out acupuncture combined TCI anesthesia,and the patients in control group was carried out TCI anesthesia. The analgesic effect was evaluated by Visual analogue scales（VAS） in 2h, 6h, 12h, 24h and 48h after operation. The percentage of peripheral blood subgroups of T-lymphocytes （CD3＋, CD4＋, CD8＋）, natural killer cell （CD16＋CD56＋） and the ratio of CD4＋/CD8＋ was detected in 30 min before anesthesia,2h after beginning of operation,1d , 2d and 5d after operation. Results he VAS scores at 2 h （2.30 ± 1.12 vs. 3.75 ± 1.06, t=2.378）, 6 h （2.64 ± 1.23 vs. 5.56 ± 1.41, t=3.289） and 12 h （3.49 ± 1.46 vs. 4.99 ± 1.27, t=2.040） after operation of acupuncture combined drugs group wwere significantly lower than those of control group （P〈0.05）. The CD3＋ （52.35% ± 4.20% vs. 48.01% ± 4.42%, t=2.127）, CD4＋ （27.81% ± 2.72% vs. 24.96% ± 2.60%, t=2.250）, CD4＋/CD8＋ （1.12 ± 0.15 vs. 1.01 ± 0.13, t=2.136） in acupuncture combined drugs group were significantly higher than those of the control group in 1d after operation （P〈0.05）. The CD16＋ CD56＋ 2 h （14.79% ± 2.04% vs. 13.58% ± 1.50%, t=2.852）, 1 d （14.43% ± 2.27% vs. 13.11% ± 1.82%, t=2.933） in acupuncture combined drugs group were significantly higher han those of control group in 2h after beginning of operation and 1d after operation （P〈0.05）. Conclusions The analgesic effect of acupuncture could be applied to radical operation of breast cancer under general anesthesia. This method could protect the subgroups of T-lymphocytes and natural killer cell, and improve th

关 键 词：乳腺肿瘤 围手术期 针刺镇痛 免疫力 T-淋巴细胞亚群 自然杀伤细胞 

分 类 号：R246.5[医药卫生—针灸推拿学]