电针预处理对胃癌根治术后老年病人免疫功能的影响  

Effect of electroacupuncture preconditioning on immune function of elderly patients after radical resection for gastric cancer

作　　者：周民涛 张彩举[1] 付金厚[1] 何金乾[1] Zhou Mintao;Zhang Caiju;Fu Jinhou;He Jinqian(Department of Anesthesiology,Nanyang First People's Hospitals Affiliated Hospital of Henan University,Nanyang 473010,China)

机构地区：[1]南阳市第一人民医院(河南大学附属医院)麻醉科,473010

出　　处：《中华麻醉学杂志》2020年第8期915-918,共4页Chinese Journal of Anesthesiology

基　　金：河南省医学科技攻关计划项目(2018020976)。

摘　　要：目的评价电针预处理对胃癌根治术后老年病人免疫功能的影响。方法择期拟行胃癌根治术病人70例,年龄65~75岁,ASA分级Ⅱ或Ⅲ级;体重指数18~25 kg/m^2,采用随机数字表法分为2组(n=35):电针预处理组(EP组)和对照组(C租)。2组病人均采用静吸复合麻醉,EP组麻醉诱导前电针刺激(连续波,频率2/100 Hz,电流为1 mA)内麻点与足三里穴30 min;C组不做电针处理,术后采用病人自控静脉镇痛。于电针刺激前、术后2、12、24和48 h(T0~4)时评定安全等级和疗效等级并抽取中心静脉血样,采用流式细胞仪测定CD3^+、CD4^+和CD8^+T细胞百分比,计算CD4^+/CD8^+比值。结果2组病人术后安全等级及其1级率和疗效等级及其优良率差异无统计学意义(P>0.05)。与T0时比较,C组T1~4时血清CD3^+、CD4^+T细胞百分比和CD4^+/CD8^+比值、T3时CD8^+T细胞百分比降低(P<0.05)。与C组比较,EP组T1~4时血清CD3^+、CD4^+T细胞百分比和CD4^+/CD8^+比值、T3时CD8^+T细胞百分比升高(P<0.05)。结论电针刺激内麻点与足三里穴预处理可改善胃癌根治术后老年病人的免疫功能。Objective To evaluate the effect of electroacupuncture preconditioning on the immune function of elderly patients after radical resection for gastric cancer.Methods A total of 70 patients,aged 65 to 75 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for gastric cancer,of American Society of Anesthesiology physical statusⅡorⅢ,were divided into 2 groups(n=35 each)by a random number table method:electroacupuncture pretreatment group(group EP)and control group(group C).Combined intravenous-inhalational anesthesia was used in both groups.In group EP,electroacupuncture(continuous wave,frequency 2/100Hz,current 1 mA)of the internal anesthesia point and Zusanli acupoint was performed for 30 min before induction of anesthesia.In group C,electroacupuncture was not performed,and patient-controlled intravenous analgesia was used after operation.Before electroacupuncture and at 2,12,24 and 48 h after operation(T0-4),the rating of safety and efficacy was assessed,and central venous blood samples were collected,and the percentages of CD3^+,CD4^+ and CD8^+ T cells were measured by flow cytometry,and the CD4^+/CD8^+ ratio was calculated.Results There was no significant difference in the rating of safety and efficacy between the two groups(P>0.05).Compared with the baseline at T0,the percentages of serum CD3^+ and CD4^+ T cells and CD4^+/CD8^+ ratio at T1-4 and percentage of CD8^+ T cells at T3 were significantly decreased in group C(P<0.05).Compared with group C,the percentages of serum CD3^+ and CD4^+ T cells and CD4^+/CD8^+ ratio at T1-4 and percentage of CD8^+ T cells at T3 were significantly increased in group EP(P<0.05).Conclusion Electroacupuncture of internal anesthesia points and Zusanli acupoint preconditioning can improve the immune function of elderly patients after radical resection for gastric cancer.

关 键 词：电针 胃肿瘤 老年人 免疫 细胞 

分 类 号：R735.2[医药卫生—肿瘤]