Clinical observation of point injection at Zusanli(ST36)plus abdominal point application for gastrointestinal dysfunction after laparoscopic surgery  

足三里穴位注射联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱临床观察

作　　者：TANG Huanfeng YUAN Dawei WANG Hua SU Ruxue QIN Limin LIU Jingrui LÜ Bingtao 唐焕峰;袁大为;王华;苏汝学;秦利民;刘井瑞;吕炳涛(Qinhuangdao Hospital of Traditional Chinese Medicine,Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]Qinhuangdao Hospital of Traditional Chinese Medicine,Hebei Province,Qinhuangdao 066000,China

出　　处：《Journal of Acupuncture and Tuina Science》2025年第1期36-42,共7页针灸推拿医学(英文版)

基　　金：秦皇岛市科学技术研究与发展计划项目,No.202101A071。

摘　　要：Objective:To observe the effect of point injection at Zusanli(ST36)plus abdominal point application on gastrointestinal dysfunction after laparoscopic surgery.Methods:A total of 204 patients with gastrointestinal dysfunction after laparoscopic surgery were recruited and divided into four groups using the random number table method,with 51 cases in each group.The control group received conventional postoperative intervention.In addition to the treatment in the control group,the point injection group was given point injection at Zusanli(ST36),the application group was offered abdominal point application,and the integrated group received point injection at Zusanli(ST36)and abdominal point application.The treatment lasted 3 consecutive days in all four groups.The recovery time of gastrointestinal function indicators and the incidence rate of postoperative nausea and vomiting(PONV)were observed and recorded.Before and after treatment,the visual analog scale(VAS)was used to assess abdominal pain intensity,the venous blood type 1 helper T cells/type 2 helper T cells(Th1/Th2)was determined,the serum levels of interleukin(IL)-6 and interferon(IFN)-γwere detected using the enzyme-linked immunosorbent assay,and the plasma levels of motilin and gastrin were measured using radioimmunoassay.Results:Compared to the control group,the first exhaust time,the first defecation time,and the time of restoring fluid diet came earlier in the other three groups(P<0.05)and were earlier in the integrated group than in the point injection and application groups(P<0.05).The point injection,application,and integrated groups had a lower PONV incidence rate than the control group,and the integrated group was lower than the point injection and application groups(P<0.05).The intra-group comparisons showed that the VAS score and the levels of IL-6 and INF-γdecreased after treatment in all four groups(P<0.05);the point injection,application,and integrated groups were lower than the control group(P<0.05),and the integrated group was lower than the目的:观察足三里穴位注射联合腹部穴位贴敷对腹腔镜术后胃肠功能紊乱的影响。方法:选择204例腹腔镜术后胃肠功能紊乱患者作为研究对象。采用随机数字表法分为4组,每组51例。对照组给予外科术后常规治疗;穴位注射组在对照组基础上应用足三里穴位注射;贴敷组在对照组基础上应用腹部穴位贴敷;联合组在对照组基础上应用足三里穴位注射联合腹部穴位贴敷。四组均连续治疗3 d。观察记录胃肠功能相关指标恢复时间及术后恶心呕吐(PONV)发生率;治疗前后采用视觉模拟量表(VAS)评定术后腹部疼痛程度;检测静脉血中1型辅助性T细胞/2型辅助性T细胞(Th1/Th2);采用酶联免疫吸附法检测血清白细胞介素(IL)-6和干扰素-γ水平;采用放射免疫分析法检测血浆胃动素和胃泌素水平。结果:穴位注射组、贴敷组及联合组的首次排气时间、首次排便时间及恢复流质饮食时间均短于对照组(P<0.05),且联合组短于穴位注射组和贴敷组(P<0.05)。穴位注射组、贴敷组和联合组PONV发生率均低于对照组,联合组低于穴位注射组和贴敷组(P<0.05)。与同组治疗前比较,4组治疗后的VAS评分、IL-6及干扰素-γ均降低(P<0.05),且穴位注射组、贴敷组及联合组均低于对照组(P<0.05),联合组低于穴位注射组和贴敷组(P<0.05)。与同组治疗前比较,4组治疗后的Th1/Th2、胃动素、胃泌素均升高(P<0.05),且穴位注射组、贴敷组及联合组均高于对照组(P<0.05),联合组高于穴位注射组和贴敷组(P<0.05)。结论:足三里穴位注射联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱可促进患者术后排气和排便,帮助恢复流质饮食,缓解术后腹部疼痛,减少PONV发生,调节Th1/Th2免疫平衡和胃动素、胃泌素的分泌。

关 键 词：HYDRO-ACUPUNCTURE Acupoint Sticking Therapy Point Zusanli(ST36) LAPAROSCOPY Postoperative Complications Gastrointestinal Dysfunction Th1-Th2 Balance Randomized Controlled Trial 

分 类 号：R245.9[医药卫生—针灸推拿学]