经皮穴位电刺激对腹腔镜直肠癌根治术患者胃肠激素及免疫功能的影响  

Effect of Transcutaneous Acupoint Electrical Stimulation on Gastrointestinal Hormones and Immune Function in Patients Undergoing Laparoscopic Radical Resection of Rectal Cancer

作　　者：宋宇龙[1] 宋文英[1] 丁慧[1] 黄彦逵 SONG Yulong;SONG Wenying;DING Hui;HUANG Yankui(Shaanxi People's Hospital,Xi'an Shaanxi China 710068;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Guangzhou China 510440)

机构地区：[1]陕西省人民医院,陕西西安710068 [2]广州中医药大学第一附属医院,广东广州510440

出　　处：《中医学报》2020年第1期210-214,共5页Acta Chinese Medicine

基　　金：广东省中医药管理局课题项目(20172054)。

摘　　要：目的:探讨经皮穴位电刺激(transcutaneous acupoint electrical stimulation,TEAS)对腹腔镜直肠癌根治术患者胃肠激素及免疫功能的影响。方法:全麻下行腹腔镜直肠癌根治术患者92例按照随机数字表法随机分成观察组(n=46)与对照组(n=46)。两组均采用全凭静脉麻醉,观察组于麻醉诱导前30 min取百会、内关、足三里及三阴交穴,连接经皮穴位刺激仪行电针持续刺激直至术毕,对照组则接受假针刺处理。分别于手术后12、24、48 h统计两组舒芬太尼用量;并于手术前及手术后1、3、5 d检测两组外周血T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)及自然杀伤细胞(natural killer cell,NK)表达水平和血清胃动素(motilin,MTL)水平;同时比较两组患者手术后胃肠功能恢复情况。结果:观察组手术后12、24、48 h舒芬太尼用量均显著低于同期对照组(P<0.05)。两组患者手术后1 d外周血CD3^+、CD4^+、NK水平及CD4^+/CD8^+均明显低于手术前(P<0.05);手术后3、5 d逐渐升高,但均以观察组上升更明显(P<0.05);且观察组手术后5 d外周血CD3^+、CD4^+、NK水平和CD4^+/CD8^+均显著高于手术前(P<0.05)。两组患者手术后1 d血清MTL水平均显著低于手术前(P<0.05),手术后3、5 d逐渐升高;其中观察组手术后1、3 d血清MTL水平均显著高于同期对照组(P<0.05)。观察组手术后肠鸣音恢复时间、首次排气时间及首次排便时间均显著短于对照组(P<0.05)。结论:TEAS能有效调节腹腔镜直肠癌根治术患者手术后胃肠激素水平,加快胃肠功能恢复,并能有效提高直肠癌患者的免疫功能。Objective:To investigate the effect of transcutaneous acupoint electrical stimulation(TEAS)on gastrointestinal hormones and immune function in patients undergoing laparoscopic radical resection of rectal cancer.Methods:92 cases of laparoscopic rectal cancer radical operation under general anesthesia were randomly divided into observation group(n=46)and control group(n=46).The observation group was given Baihui,Neiguan,Zusanli and Sanyinjiao acupoints 30 minutes before the induc-tion of anesthesia,and connected with the transcutaneous acupoint stimulator for continuous electroacupuncture until the end of the operation,while the control group received sham acupuncture treatment.The dosage of sufentanil was calculated at 12,24 and 48 hours after operation;the levels of T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+),natural killer cell(NK)and serum motilin(MTL)were measured before and 1,3 and 5 days after operation,and the recovery of gastrointestinal function was compared between the two groups.Results:The dosage of sufentanil in the observation group at 12,24 and 48 hours after operation was significantly lower than that in the control group(P<0.05).The levels of CD3+,CD4+,NK and CD4+/CD8+in the peripheral blood of the two groups were significantly lower than those before operation(P<0.05);the levels of CD3+,CD4+,NK and CD4+/CD8+in the observation group were significantly higher than those before operation(P<0.05).The level of serum MTL in the two groups was significantly lower than that before operation(P<0.05),and gradually increased on the 3rd and 5th day after operation.The level of serum MTL in the observation group was significantly higher than that in the control group(P<0.05).The recovery time,first exhaust time and first defecation time in the observation group were significantly shorter than those in the control group(P<0.05).Conclusion:TEAS can effectively regulate the level of gastrointestinal hormones,accelerate the recovery of gastrointestinal function,and effectively improve the immune function of re

关 键 词：经皮穴位电刺激 腹腔镜直肠癌根治术 舒芬太尼 胃肠激素 胃动素 免疫功能 中西医结合 

分 类 号：R245.97[医药卫生—针灸推拿学]