经皮穴位电刺激对腹腔镜肠道手术围术期炎性反应和肠黏膜通透性的影响  

Transcutaneous electrical acupoint stimulation on inflammatory response and intestinal permeability in perioperative period of laparoscopic intestinal surgery

作　　者：郭君[1] 唐炜[1] 郭丰[1] 杨黎明[1] 王剑[1] 傅国强[1] 袁岚[1] GUO Jun;TANG Wei;GUO Feng;YANG Liming;WANG Jiani FU Guoqiang;YUAN Lan(Department of Anesthesiology,Shuguang Hospital,Affiliated to Shanghai UniVersity of TCM,Shanghai 201203i China)

机构地区：[1]上海中医药大学附属曙光医院麻醉科,上海201203

出　　处：《中国针灸》2018年第10期1043-1046,共4页Chinese Acupuncture & Moxibustion

基　　金：上海市卫生和计划生育委员会中医药科研基金资助项目:2014 LP 091 B;国家自然科学基金青年科学基金项目:81503395

摘　　要：目的:观察经皮穴位电刺激(TEAS)对腹腔镜结直肠癌根治手术患者术后炎性反应和肠黏膜通透性的影响,探讨TEAS在围术期脏器保护方面的作用机制。方法:将60例择期行腹腔镜直肠癌根治手术患者随机分为观察组和对照组,每组30例。观察组在手术当天及术后3 d内每天给予足三里、内关、合谷经皮穴位电刺激治疗1次,频率2 Hz,刺激强度选择患者能耐受的最适宜强度(不超过2 m A)。对照组操作同观察组,但不开启电源。检测术前(TEAS前)及术后12、24、48、72 h各时间点血浆炎性反应指标肿瘤坏死因子(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6);肠黏膜屏障反应指标内毒素(LPS)含量及D-乳酸水平。结果:与对照组相比,观察组术后24、48、72 h炎性因子IL-1、IL-6及TNF-α含量降低(均P<0.05);D-乳酸、LPS水平组间比较差异无统计学意义(均P>0.05)。结论:经皮穴位电刺激可以减轻腹腔镜直肠癌患者术后炎性反应,但对肠道黏膜通透性无影响。Objective To observe the effect of transcutaneous electrical acupoint stimulation（TEAS） on the inflammatory response and intestinal permeability after laparoscopic radical surgery for colon cancer, so as to explore the protective mechanism for perioperative organs. Methods Sixty patients with laparoscopic intestinal resection were randomly assigned into an observation group and a control group, 30 cases in each group. TEAS at Zusanli（ST 36）, Neiguan（PC 6） and Hegu（LI 4） was used in the observation group on the day of operation and within 3 days after surgery, 2 Hz, within 2 m A. The interventions in the control group were the same as those in the observation group, except opening the current source. Central venous blood was collected before TEAS and 12 h, 24 h, 48 h, 72 h after surgery. The level of the inflammatory indexes of tumor necrosis factor-α（TNF-α）, interleukin-1（IL-1）, interleukin-6（IL-6） and intestinal mucosal barrier response indexes of endotoxin（LPS） and D-lactate were detected. Results Compared with the control group, the levels of IL-1, IL-6 and TNF-α decreased in the observation group 24 h, 48 h and 72 h after surgery（all P〈0.05）. The concentrations of D-lactate and LPS were not statistically different between the two groups（both P〉0.05）. Conclusion TEAS can reduce the inflammatory reaction after laparoscopic radical surgery for colon cancer, but has no effect on the intestinal permeability.

关 键 词：经皮穴位电刺激 腹腔镜肠道手术 炎性反应 肠黏膜通透性 穴 内关 穴 足三里 穴 合谷 

分 类 号：R246.2[医药卫生—针灸推拿学]