单穴针刺与多穴针刺对全麻腹腔镜胆囊切除术后患者胃肠功能的影响  

Electroacupuncture of both single- and multi-acupoints promotes recovery of gastrointestinal function in laparoscopic cholecystectomy patients

作　　者：曲立哲[1] 赵宏程[2] 沈韩雄[1] 严赟[1] 马思杰[1] 王开强[1] QU Li-zhe;ZHAO Hong-cheng;SHEN Han-xiong;YAN Yun;MA Si-jie;WANG Kai-qiang(Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071 China;Anesthesiology Department,Shanghai Tenth People's Hospital,Shanghai 200072)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]上海市第十人民医院麻醉科,上海200072

出　　处：《针刺研究》2020年第2期136-140,共5页Acupuncture Research

基　　金：国家自然科学基金青年项目(No.81804122);上海市新兴前沿技术联合攻关项目(No.SHDC12013126);上海市中医优势病种培育项目[No.ZY(2018-2020)-ZYBZ-06]

摘　　要：目的:观察并比较针刺足三里单穴与针刺足三里、上巨虚及内关多穴对全麻腹腔镜胆囊切除术后患者胃肠功能的影响。方法:选择气管内插管全身麻醉腹腔镜胆囊手术患者70例,ASAⅠ-Ⅱ级,随机分为对照组(23例)、单穴针刺组(23例)和多穴针刺组(24例)。对照组患者仅给予常规基础治疗。术前30 min,单穴针刺组给予电针双侧足三里,频率为10 Hz,电流强度为5 mA,持续刺激30 min;手术结束后4、22、34、46 h各行针刺治疗1次。多穴针刺组给予电针双侧足三里、上巨虚和内关,电针参数和时程长度同单穴针刺组。记录分析3组患者术后肛门排气排便时间、肠鸣音恢复时间、腹胀及恶心呕吐发生的情况。结果:与对照组比较,单穴针刺组和多穴针刺组患者肠鸣音恢复时间、首次排气及排便时间均明显缩短(P<0.01,P<0.05,P<0.001),术后24 h腹胀和恶心呕吐的发生频数均明显降低(P<0.05)。单穴针刺组和多穴针刺组患者在肠鸣音恢复时间、肛门排气排便时间、术后腹胀及恶心呕吐发生率等各方面均差异无统计学意义(P>0.05)。结论:单穴针刺与多穴针刺均可促进全麻腹腔镜胆囊手术患者术后的胃肠功能恢复,且单穴针刺与多穴针刺对患者术后的胃肠功能恢复影响无明显差异。Objective To compare the therapeutic effect of electroacupuncture(EA) of single-acupoint Zusanli(ST36) and multi-acupoints Zusanli(ST36), Shangjuxu(ST37) and Neiguan(PC6) in promoting the recovery of gastrointestinal movement in laparoscopic cholecystectomy(LC) patients undergoing general anesthesia. Methods A total of 70 LC patients(American Society of Anesthesiologists [ASA] grade I and II) were recruited and randomly divided into control(n=23), single ST36(n=23) and ST36+ST37+PC6(n=24) groups. The patients in the control group only received routine basic treatments(postoperative fasting and water deprivation, intravenous drip of biotics, water-electrolyte and acid-base balancing, oxygen uptake, etc). EA(10 Hz, 5 mA, 30 min every time) was applied to the abovementioned single-acupoint or multi-acupoints groups before, and 4, 22, 34 and 46 h after the operation. The time-points of postoperative borborygmus recovery, first anal exhaust and defecation, post-operative abdominal distension(mild, moderate and severe), nausea and vomiting(grade Ⅰ, Ⅱ, Ⅲ and Ⅳ) at 6, 24 and 48 h after surgery were recorded and analyzed. Results Compared to the control group, the time of borborygmus recovery, first anal exhaust and defecation were markedly earlier in both single ST36 and ST36+ST37+PC6 groups(P<0.01, P<0.05, P<0.001). The number of patients who had mild plus moderate abdominal distention, and nausea(grade Ⅱ+Ⅲ) at 24 h after ope-ration was significantly lower in both single ST36 and ST36+ST37+PC6 groups than in the control group(P<0.05). No significant differences were found between the two EA groups in the time of borborygmus recovery, first anal exhaust and defecation, and in the number of patients with mild plus moderate abdominal distention and those with nausea(P>0.05). Conclusion EA of both single ST36 and ST36+ST37+PC6 can promote gastrointestinal function recovery in LC patients, without remarkable difference between them.

关 键 词：腹腔镜胆囊切除术 电针 单穴 多穴 胃肠运动 

分 类 号：R246.2[医药卫生—针灸推拿学]