足三里注射联合腹部穴位贴敷对腹腔镜术后胃肠功能恢复及免疫功能、炎症状态的影响  

Effect of Zusanli injection combined with abdominal acupoint application on gastrointestinal function recovery,immune function and inflammatory state after laparoscopic surgery

作　　者：袁大为 唐焕峰[1] 王华 苏汝学 刘井瑞 吕炳涛 YUAN Dawei;TANG Huanfeng;WANG Hua;SU Ruxue;LIU Jingrui;LV Bingtao(Department of General Surgery,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei,066000,China)

机构地区：[1]秦皇岛市中医医院普通外科,河北秦皇岛066000

出　　处：《中国中西医结合消化杂志》2024年第12期1111-1115,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：秦皇岛市科学技术研究与发展计划项目(No:202101A071)。

摘　　要：目的:探讨足三里注射、腹部穴位贴敷联合治疗应用于腹腔镜术后患者的临床疗效,及其对胃肠功能恢复及免疫功能、炎症状态的影响。方法:选取2021年1月—2024年1月秦皇岛市中医医院收治的192例行腹腔镜手术患者作为研究对象,采用随机数字表法分为A、B、C、D 4组,每组48例。A组给予外科术后常规治疗,B组在A组基础上予以足三里注射治疗,C组在A组基础上予以腹部穴位贴敷治疗,D组在A组基础上应用足三里注射、腹部穴位贴敷联合治疗。4组治疗时间均为3 d。比较4组患者胃肠功能(首次出现肠鸣音时间、首次排便时间、首次排气时间)、免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、炎症状态[白细胞介素(IL)-6、IL-10、肿瘤坏死因子-α(TNF-α)]以及术后呕吐、腹胀发生情况。结果:B、C、D组患者首次出现肠鸣音时间、首次排便时间、首次排气时间均短于A组(P<0.05),D组患者短于B、C组(P<0.05)。治疗后4组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高(P<0.05),B、C、D组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于A组(P<0.05),D组高于B、C组(P<0.05)。治疗后4组患者IL-6、IL-10、TNF-α水平均降低(P<0.05),B、C、D组IL-6、IL-10、TNF-α水平低于A组(P<0.05),D组低于B、C组(P<0.05)。D组患者术后呕吐、腹胀发生率均低于A组(P<0.05)。结论:腹腔镜术后患者应用足三里注射、腹部穴位贴敷联合治疗有助于促进肠道功能恢复,提高机体免疫功能,改善炎症状态,减少术后并发症发生。Objective:To investigate the clinical effectiveness of combining Zusanli injection with abdominal acupoint application in enhancing gastrointestinal function recovery,immune response,and mitigating inflammatory conditions among patients post laparoscopic surgery.Methods:A total of 192 patients undergoing laparoscopic procedures at Qinhuangdao Hospital of Traditional Chinese Medicine between January 2021 and January 2024 were enrolled and randomly assigned to four groups(A,B,C,D;n=48 each)by random number table method.Group A received standard postoperative care,while Group B additionally received Zusanli injection,Group C received abdominal acupoint application,and Group D received both interventions.The treatment duration for all groups was 3 days.The gastrointestinal function(time to first bowel sounds,first defecation,and first flatus),immune function(differentiation cluster[CD]3^(+),CD4^(+),CD4^(+)/CD8^(+)),inflammatory state(interleukin-6[IL-6],interleukin-10[IL-10],tumor necrosis factor-α[TNF-α])and the incidence of postoperative vomiting and abdominal distension were compared among the four groups.Results:Groups B,C,and D exhibited shorter times to first bowel sounds,first defecation,and first flatus compared to Group A(P<0.05),with Group D showing the shortest durations(P<0.05).Post-treatment,all groups demonstrated increased levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)(P<0.05),but Groups B,C,and D had higher levels than Group A(P<0.05),with Group D leading(P<0.05).Inflammatory markers IL-6,IL-10,and TNF-αdecreased across all groups(P<0.05),with Groups B,C,and D showing lower levels than Group A(P<0.05),and Group D exhibiting the lowest levels(P<0.05).Group D also reported lower incidences of postoperative vomiting and abdominal distension compared to Group A(P<0.05).Conclusion:The combination of Zusanli injection and abdominal acupoint application in patients after laparoscopic surgery facilitates gastrointestinal function recovery,bolsters immune function,alleviates inflammatory responses,and reduces

关 键 词：腹腔镜 足三里 穴位贴敷 胃肠功能 免疫功能 炎症状态 

分 类 号：R656[医药卫生—外科学]