电针足三里治疗术后肠麻痹临床疗效及其对胆碱能抗炎通路影响的研究  

Clinical Efficacy of Electroacupuncture at Zusanli(ST36)in the Treatment of Postoperative Intestinal Paralysis and Its Effect on Cholinergic Anti-inflammatory Pathways

作　　者：李群 杨先玉[1] 陈盼敏 郑慧华[1] 喻敏 LI Qun;YANG Xianyu;CHEN Panmin;ZHENG Huihua;YU Min(Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,Jiangxi,China)

机构地区：[1]江西中医药大学,江西南昌330006

出　　处：《辽宁中医药大学学报》2023年第9期172-177,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：江西省中医药科研课题项目(2019A352)。

摘　　要：目的观察电针足三里结合西医常规疗法治疗腹部术后肠麻痹的临床疗效及其对炎症因子水平的影响,探讨该疗法通过促进术后肠麻痹患者胃肠功能恢复来激活胆碱能抗炎通路的机制。方法纳入符合术后肠麻痹标准诊断的150例患者,按照数字随机表分为A组(电针足三里+常规)50例,B组(普通针刺足三里+常规)50例,C组(常规)50例,3组患者均予以术后肠麻痹西医常规治疗及护理;B组经常规治疗后于左右两侧对称的足三里行针;A组于两侧足三里行针灸针治疗后,将电针治疗仪与针柄相连,调整连续波频率,将电流强度调整到患者可接受的范围,留针30 min,2次/d,连续治疗7 d。记录实际结果,直至患者康复、各项指标恢复后出院为止。记录术后初次肛门排气时间点、术后初次排便时间、术后肠活动时间、术后伴随典型症状消失时间(腹胀、腹痛、恶心、呕吐、饥饿)、术后第1次进食时间、术后患者住院时间、半卧位时间和下床时间,分别进行各组组内、组间对比;分别取术前和治疗后1、3、7 d白细胞(WBC)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素1β(IL-1β)、血清淀粉样蛋白A(SAA)、胃动素(MTL)结果及临床疗效比较3组是否有差异。观察不良反应。结果经治疗后,术后初次肛门排气时间点、术后初次排便时间、术后肠活动时间、术后伴随典型症状消失时间(腹胀、腹痛、恶心、呕吐、饥饿)、术后第1次进食时间、术后患者住院时间A组均早于B、C组(P<0.01),在半卧位时间比较差异无统计学意义(P>0.05);在WBC、TNF-α、IL-6、CRP、PCT、IL-1β、SAA、MTL等指标上,A组均低于B、C组,差异具有统计学意义(P<0.01);从临床总有效率比较来看,A组较其他2组有更高的有效率(P<0.01),无不良反应。结论电针足三里治疗术后肠麻痹可改善临床症状,促进胃肠功能恢复,缩Objective To observe the clinical efficacy of electroacupuncture Zusanli(ST36)combined with conventional Western medicine therapy in the treatment of intestinal paralysis after abdominal surgery and its effect on the level of inflammatory factors,and to explore whether this therapy can promote the recovery of gastrointestinal function in patients with postoperative intestinal paralysis and activate choline mechanisms of anti-inflammatory pathways.Methods A total of 150 patients who met the criteria of postoperative intestinal paralysis were included and divided into group A(electroacupuncture at Zusanli(ST36)+routine)50 cases,group B(ordinary acupuncture+routine)50 cases,and group C(routine)50 cases,all the patients in the three groups received conventional treatment and nursing of postoperative intestinal paralysis with Western medicine;as mentioned above,group B received acupuncture in Zusanli(ST36)symmetrically on the left and right sides after conventional treatment;group A received acupuncture and moxibustion in Zusanli(ST36)on both sides after the acupuncture treatment,connect the electroacupuncture therapeutic apparatus to the needle handle,adjust the frequency of the continuous wave,adjust the current intensity to the acceptable range of the patient,and keep the needle for 30 minutes,twice a day,for 7 consecutive days.The actual results were recorded until the patients'symptoms recovered and the treatment of various indicators recovered and he was discharged from the hospital.The time point of the first anal exhaust after operation,the time of first defecation after operation,the time of bowel movement after operation,the time of disappearance of typical symptoms after operation(abdominal distention,abdominal pain,nausea,vomiting,hunger),and the time of first eating after operation were recorded.The intra-group and inter-group comparisons were carried out in each group,respectively;the white blood cells(WBC),tumor necrosis factor(WBC)and tumor necrosis factor-alpha(TNF-α),interleukin 6(IL-6),C-reactive p

关 键 词：电针 足三里 术后肠麻痹 胆碱能抗炎通路 炎性因子 

分 类 号：R245.97[医药卫生—针灸推拿学] R574[医药卫生—中医临床基础]