耳穴贴压改善家兔腹部术后胃肠功能的作用机制研究  

The mechanism where by auricular acupoints plastering improves gastrointestinal motility after abdominal surgery in rabbits

作　　者：黄惠榕[1] 薛佳璐 余真铃 余梦霞 吴翠娟 仇志琴 Huang Huirong;Xue Jialu;Yu Zhenling;Yu Mengxia;Wu Cuijuan;Qiu Zhiqin(Nursing Department,The People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院护理部,福建福州350004 [2]福建中医药大学护理学院

出　　处：《护理学杂志》2022年第15期43-45,60,共4页Journal of Nursing Science

基　　金：中华护理学会科研课题(ZHKY201923)。

摘　　要：目的探讨耳穴贴压对腹部术后胃肠功能紊乱家兔模型的作用机制,为耳穴贴压治疗腹部术后胃肠功能紊乱提供参考。方法将30只SD清洁型家兔采用随机数字表法分为空白组、模型组、耳穴组各10只。耳穴组于造模成功后耳穴贴压胃、大肠、耳中穴,每日按压3次,每次每穴30 s,连续干预7 d;模型组进行造模手术未进行耳穴贴压;空白组不给予任何处理。结果耳穴组术后首次排便时间及肠鸣音恢复时间显著早于模型组(均P<0.05)。三组术后6 h、3 d及7 d血清皮质醇浓度的干预效应、时间效应、交互效应显著,模型组及耳穴组术后6 h及3 d血清皮质醇浓度显著高于空白组,且术后3 d耳穴组显著低于模型组(均P<0.05)。干预后,三组小肠推进率、C-kit蛋白阳性表达、iNOS活性有显著差异,其中耳穴组、空白组小肠推进率、C-kit蛋白阳性表达显著高于模型组,但iNOS活性显著低于模型组,耳穴组的C-kit蛋白阳性表达显著低于空白组(均P<0.05)。结论耳穴贴压可缩短腹部术后家兔首次排便及肠鸣音恢复时间,降低血清皮质醇浓度及应激反应,有助于提升小肠推进率及结肠组织中C-kit蛋白阳性表达,促进腹部术后胃肠蠕动恢复。Objective To explore the mechanism of auricular acupoints plastering on the rabbit model with gastrointestinal disorder after abdominal surgery,and to provide reference for auricular acupoint plastering treating gastrointestinal dysfunction after abdominal surgery.Methods A total of 30 SD clean rabbits were divided into a blank group,a model group and an auricular acupoint plastering group using a random number table,with 10 rabbits in each group.After successful modeling,the auricular acupoint plastering group were pressed the acupoints of stomach,large intestine and Erzhong three times a day,30 seconds each time per acupoint,lasting 7 days.The model group received modeling surgery without plastering,and the blank group wasn′t handled.Results The first postoperative defecation and bowel sound recovery in the auricular acupoints plastering group were significantly ear-lier than those in the model group(P<0.05 for both).The intervention effect,time effect and intervention×time effect of serum cortisol concentration in the three groups at 6 hours,3 days and 7 days after surgery were significant,the serum cortisol concentration of the blank group at 6 hours and 3 days after surgery were significantly lower than those of the other two groups,and it was significantly lower in the auricular acupoint plastering group than the model group at 3 days after surgery(P<0.05 for all).After the intervention,there were significant differences in the small intestine advancement rate,C-kit protein positive expression and iNOS activity among the three groups,and the small intestine advancement rate and C-kit protein positive expression in the model group were significantly lower than those in the other two groups,while its activity of iNOS was significantly higher,and the positive expression of C-kit protein in the auricular point plastering group was significantly lower than that in the blank group(P<0.05 for all).Conclusion Auricular acupoint plastering can accelerate the occurring of first defecation and bowel sound recovery

关 键 词：家兔 耳穴贴压 结肠吻合术 胃肠功能 应激反应 首次排便时间 肠鸣音恢复时间 血清皮质醇浓度 小肠推进率 C-KIT蛋白 诱导型一氧化氮合酶活性 

分 类 号：R47[医药卫生—护理学] R248[医药卫生—临床医学]