经皮穴位电刺激对冠状动脉旁路移植术患者术后免疫功能抑制的改善作用  

Improvement of transcutaneous electrical acupoint stimulation on postoperative immunosuppression in patients receiving coronary artery bypass grafting

作　　者：解建[1] 袁岚[1] 傅国强[1,2] 陈文婷[1] XIE Jian;YUAN Lan;FU Guoqiang;CHEN Wenting(Department of Anesthesiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;Acupuncture and Anesthesia Research Institute, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203 , 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 [2]上海中医药大学附属曙光医院针麻研究所,上海201203

出　　处：《上海中医药大学学报》2019年第3期43-47,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金资助项目(81603450);上海市卫计委科研项目(20154Y0111)

摘　　要：目的:评估经皮穴位电刺激(TEAS)对冠状动脉旁路移植术(CABG)患者术后免疫功能抑制的改善作用。方法:纳入择期接受体外循环下CABG患者,共计88例,随机分为TEAS组44例和经皮穴位假电刺激组(SHAM TEAS组)44例。所有患者均行全麻下的CABG,TEAS组患者于术前、术中及术后给予TEAS干预,SHAM TEAS组患者相应给予假TEAS干预。于术前1 d及术后1 d、3 d、5 d检测两组患者的白介素-6(IL-6)、C反应蛋白(CRP)水平,比较两组患者的术后继发感染情况。结果:与术前比较,术后1 d两组患者的血清IL-6水平明显上升(P<0.01),术后5 d两组患者的血清IL-6水平明显下降(P<0.01);术后5 d,SHAM TEAS组患者的血清IL-6水平明显低于TEAS组(P<0.05)。与术前比较,术后3 d、5 d两组患者的血清CRP水平均显著升高(P<0.01);术后1 d、3 d、5 d,两组患者的血清CRP水平比较,差异均无统计学意义(P>0.05)。术后SHAM TEAS组患者肺部感染的发生率显著高于TEAS组(P<0.01)。结论:围手术期TEAS能够通过增强适应性免疫功能,改善体外循环下CABG患者的术后免疫功能抑制。Objective: To evaluate the improvement of transcutaneous electrical acupoint stimulation(TEAS) on the postoperative immunosuppression in patients receiving coronary artery bypass grafting(CABG). Methods: A total of 88 patients who were scheduled to receive CABG under extracorporeal circulation were included, and randomly divided into the TEAS group(44 cases) and the SHAM TEAS group(44 cases). All the patients were treated with CABG under general anesthesia. Before operation, in the course of operation, and after operation, the patients in the TEAS group were treated with TEAS, and the patients in the SHAM TEAS group were treated with sham TEAS. One day before operation, and one day, three days and five days after operation, the levels of interleukin-6(IL-6) and C-reactive protein(CRP) were detected, and the secondary infection after operation was compared between the two groups. Results: Compared with before operation, the serum level of IL-6 in both groups was obviously increased one day after operation(P<0.01), and the serum level of IL-6 in both groups was obviously decreased five days after operation(P<0.01). Five days after operation, the serum level of IL-6 in the SHAM TEAS group was significantly lower than that in the TEAS group(P<0.05). Compared with before operation, the serum level of CRP in both groups was obviously increased three days and five days after operation(P<0.01). One day, three days and five days after operation, there were no statistically significant differences on the serum level of CRP between the two groups(P>0.05). The incidence rate of postoperative lung infection in the SHAM TEAS group was significantly higher than that in the TEAS group(P<0.01). Conclusion: Perioperative TEAS can improve the postoperative immunosuppression of patients receiving CABG under extracorporeal circulation by enhancing adaptive immune function.

关 键 词：冠状动脉旁路移植术 经皮穴位电刺激 免疫抑制 IL-6 CRP 

分 类 号：R654.2[医药卫生—外科学]