针刺辅助麻醉对脊柱手术患者细胞免疫功能的影响  

Effects of Acupuncture-Assisted Anesthesia on Cellular Immune functions in Patients Undergoing Spine Surgery

作　　者：黎玉辉[1] 罗利静 李思蓓 吴欣圆 姜梦婷 马武华[1] LI Yu-Hui;LUO Li-Jing;LI Si-Bei;WU Xin-Yuan;JIANG Meng-Ting;MA Wu-Hua(The First Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Huizhou Sixth People’s Hospital,Huizhou 516211 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广东省惠州市第六人民医院,广东惠州516211 [3]广州中医药大学,广东广州510006

出　　处：《广州中医药大学学报》2020年第12期2349-2354,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技计划项目(编号:2016A020226016)。

摘　　要：【目的】观察脊柱手术患者围术期细胞免疫功能的变化情况,探讨针刺辅助麻醉对细胞免疫功能的影响。【方法】采用随机、对照及双盲试验设计,将50例患者随机分为静吸复合全麻组(对照组)及针刺辅助麻醉组(试验组),每组各25例,2组均采用相同的麻醉诱导及术中维持方式。试验组全麻插管前以2/15 Hz疏密波经皮刺激双侧足三里、三阴交30 min,诱导后以100 Hz连续波持续刺激至术毕,术后第1~3天以2/15 Hz疏密波电刺激双侧内关、太冲30 min。在麻醉诱导前、术后1 h及针刺治疗后的第1天和第3天采血检测血液分析、淋巴细胞亚群及NK细胞。【结果】(1)研究过程中,试验组退出2例,最终试验组23例、对照组25例患者完成试验。(2)术后第1天,2组患者淋巴细胞百分数、单核细胞百分数、中性粒细胞百分数及白细胞数量与同组术前比较,差异均有统计学意义(P<0.05)。术后第3天,对照组患者的淋巴细胞百分数下降、中性粒细胞百分数及白细胞数量升高,与同组术前比较,差异均有统计学意义(P<0.05);试验组患者的淋巴细胞百分数、单核细胞百分数下降,白细胞数量升高,与同组术前比较,差异均有统计学意义(P<0.05)。术后第1天和第3天,试验组淋巴细胞百分数、单核细胞百分数、中性粒细胞百分数及白细胞数量,与同期对照组比较,差异均无统计学意义(P>0.05)。(3)术后1 h,2组患者CD3+、CD4+、CD8+细胞水平均降低,CD16+、CD56+水平均升高,与同组术前比较,差异均有统计学意义(P<0.05)。术后第1天,对照组患者CD3+、CD4+、CD8+、CD4+/CD8+、CD56+水平均明显降低,CD16+水平升高,与同组术前比较,差异均有统计学意义(P<0.05);试验组CD4+、CD8+细胞水平降低,CD3+、CD4+/CD8+、CD56+、CD16+细胞水平升高,与同组术前比较,差异均有统计学意义(P<0.05)。术后第3天,对照组患者CD8+、CD4+/CD8+、CD16+、CD56+水平均明显降低,与同�Objective To observe the changes in perioperative cellular immune functions in patients undergoing spine surgery,so as to explore the effect of acupuncture-assisted anesthesia on cellular immune functions.Methods A randomized controlled and double blind trial was designed.Fifty patients were randomly assigned into general anesthesia group(control group)and cupuncture-assisted anesthesia group(experimental group),25 cases in each group.The two groups were given the same anesthetic induction and intraoperative maintenance treatment.The experimental group received percutaneous stimulation at bilateral Zusanli(ST36)and Sanyinjiao(SP6)with dilatational wave of 2/15 Hz for 30 minutes before intubation general anesthesia,and then received continuous stimulation with continuous wave of 100 Hz till the end of surgery.On postoperative day 1 to 3,electrical stimulation at bilateral Neiguan(PC6)and Taichong(LR3)with dilatational wave of 2/15 Hz for 30 minutes were performed.Routine blood test,lymphocyte subsets and NK cell were analyzed before anesthetic induction,one hour after surgery,acupuncture treatment day 1 and 3.Results(1)During the trial,2 cases from the experiment group were lost to follow-up.Ultimately,23 cases in the experimental group and 25 cases in the control group completed the experiment.(2)On postoperative day 1,the differences were significant in the percent of lymphocytes,monocytes and neutrophils,and white blood cells count in the two groups as compared to the same group before treatment(P<0.05).On postoperative day 3,the percent of lymphocytes was decreased and percent of neutrophils and white blood cells count were increased in the control group as compared to the same group before treatment(P<0.05)and the percent of lymphocytes and neutrophils was decreased,and white blood cells count was increased in the experimental group as compared to those in the same group before treatment(P<0.05).On postoperative day 1 and 3,the differences were insignificant in percent of lymphocytes,monocytes and neutrophils

关 键 词：针刺辅助麻醉 脊柱手术 免疫功能 细胞免疫 

分 类 号：R246.9[医药卫生—针灸推拿学]