电针刺激穴位对ERCP术中胆管插管及术后并发症的影响  

Effect of electroacupuncture on intraoperative biliary intubation and postoperative complications of ERCP

作　　者：刘君颖[1] 贺照霞[1] 刘玮[1] 余海洋[1] 赵文霞[1] LIU Jun-ying;HE Zhao-xia;LIU Wei;ZHAO Wen-xia(The first affliated hospital of Henan University of Chinese Medicine Zhengzhou Henan,450000 China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中西医结合肝病杂志》2022年第12期1073-1076,1080,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河南省中医药科学研究专项课题(No.2017ZY2099);国家中医药管理局全国名老中医药传承工作室建设项目(No.国中医药人教函[2018]134号)。

摘　　要：目的:探讨电针刺激足三里、上巨虚、阳陵泉、胆囊穴对内镜逆行胰胆管造影术(ERCP)中经乳头胆管插管及术后并发症的影响。方法:选取2018年1月至2021年1月河南中医药大学第一附属医院收治的胆总管结石患者150例,随机分为足阳明胃经组(足三里、上巨虚)、足少阳胆经组(阳陵泉、胆囊穴)和空白对照组各50例,记录3组患者手术中胆管插管时间、插管次数、术后淀粉酶水平、术后胰腺炎发生率及术后症状等。结果:足阳明胃经组和足少阳胆经组患者术中插管时间、插管次数、术后24 h淀粉酶水平均低于空白对照组患者(P<0.05),且术后高淀粉酶血症发生率降低(P<0.05);3组患者经手术后疼痛程度均有所下降,足少阳胆经组患者术后48 h疼痛程度明显低于空白对照组患者(P<0.05),3组患者术后腹胀程度明显高于术前,足阳明胃经组和足少阳胆经组患者术后24 h腹痛程度均明显低于空白对照组患者,且足阳明胃经组患者腹胀程度最低(P<0.05)。结论:胆总管结石患者ERCP术前、术中电针刺激足三里、上巨虚、阳陵泉、胆囊穴能明显减少手术插管时间和插管次数,降低术后淀粉酶水平和高淀粉酶血症的发生率,并可减轻术后腹痛、腹胀程度。Objective:To investigate the effect of electroacupuncture at Zu san li,Shang ju xu,Yang ling quan,Dan nangxue points on ERCP surgery influence of selective biliary intubation and postoperative complications.Methods:A total of 150 patients with choledocholithiasis admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from January 2018 to January 2021 were randomly divided into the stomach meridian group(Zu san li,Shang ju xu),gallbladder meridian group(Yang ling quan,Dan nangxue)and blank control group(50 cases each).The biliary intubation time,intubation times,postoperative amylase level,postoperative pancreatitis incidence and postoperative symptoms were recorded in the 3 groups.Results:The intubation time,the number of intubation times,the number of intubations,and the postoperative 24 h amylase level of stomach meridian group and gallbladder meridian group were lower than the blank control group(P<0.05),and the incidence of high amylase blood after surgery was reduced(P<0.05).The pain degree of the three groups decreased after operation,which was more obvious between gallbladder meridian group and blank control group after 48 h(P<0.05).The degree of postoperative abdominal distension in the 3 groups was significantly higher than that before surgery.The degree of abdominal pain 24 h after surgery in the stomach meridian group and gallbladder meridian group was significantly lower than that in the blank control group,and the degree of abdominal distension in the stomach meridian group was the lowest(P<0.05).Conclusion:Electroacupuncture stimulation of Zusanli,Shang Juxu,Yang lingquan and Gallbladder points before and during the operation of ERCP in patients with choledocholithiasis can significantly reduce the time and number of intubation,reduce postoperative amylase level and the incidence of hyperamylase,and alleviate postoperative abdominal pain and abdominal distension.

关 键 词：内镜逆行胰胆管造影术 电针 穴位刺激 胆管插管 

分 类 号：R575.7[医药卫生—消化系统] R245.3[医药卫生—内科学]