经皮穴位电刺激对乳腺癌改良根治术患者术后疼痛的影响  

Effect of transcutaneous electrical acupoint stimulation on postoperative pain in patients undergoing modified radical mastectomy for breast cancer

作　　者：闫莉 孙斌[2] 周美艳 张妍[2] 高飞 赵倩文 王立伟 YAN Li;SUN Bin;ZHOU Meiyan;ZHANG Yan;GAO Fei;ZHAO Qianwen;WANG Liwei(Xuzhou Clinical School of Xuzhou Medical University,Xuzhou 221004,Jiangsu Province,China;Department of Anesthesiology,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu Province;Department of Acupuncture-Moxibustion and Encephalopathy,Xuzhou Hospital of TCM)

机构地区：[1]徐州医科大学徐州临床学院,江苏徐州221004 [2]徐州市中心医院麻醉科,江苏徐州221009 [3]徐州市中医院针灸脑病科

出　　处：《中国针灸》2025年第2期162-166,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:82071903。

摘　　要：目的:观察经皮穴位电刺激(TEAS)对乳腺癌改良根治术患者术后疼痛的影响。方法:将140例择期在全身麻醉下行单侧乳腺癌改良根治术的女性患者随机分为TEAS组(70例)和假TEAS组(70例,脱落2例)。两组均于麻醉诱导前30min至术毕,术后第1、2、3天(每次30min,每天1次),于双侧内关、足三里及膻中行TEAS或假TEAS干预。于术后第1、2、3天观察两组患者疼痛视觉模拟量表(VAS)评分;于术后3、6、12个月观察患者慢性疼痛发生率;于术前及术后第1、3、7天检测患者血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10含量;记录患者术后2d内镇痛泵按压次数、补救镇痛情况以及不良反应发生情况。结果:TEAS组患者术后第1、2天VAS评分和术后3、6个月慢性疼痛发生率均低于假TEAS组(P<0.05)。术后第1、3、7天,两组患者血清TNF-α、IL-6、IL-10含量较术前升高(P<0.05,P<0.01);TEAS组患者血清TNF-α、IL-6、IL-10含量低于假TEAS组(P<0.05)。TEAS组术后镇痛泵按压次数及补救镇痛发生率均低于假TEAS组(P<0.05);两组患者术后不良反应发生情况比较差异无统计学意义(P>0.05)。结论:TEAS可有效改善乳腺癌改良根治术患者术后急性和慢性疼痛,其机制可能与抑制炎性反应有关。Objective To observe the effect of transcutaneous electrical acupoint stimulation(TEAS)on postoperative pain in patients undergoing modified radical mastectomy for breast cancer.Methods A total of 140 female patients scheduled for unilateral modified radical mastectomy for breast cancer undergoing general anesthesia were randomized into a TEAS group(70 cases)and a sham TEAS group(70 cases,2 cases dropped out).Patients in both groups received TEAS or sham TEAS at bilateral Neiguan(PC6),Zusanli(ST36),and Danzhong(CV17),respectively,from 30 min before anesthesia induction until the end of surgery,and on 1st,2nd,and 3rd days after surgery for 30 min a time,once a day.On 1st,2nd,and 3rd days after surgery,the pain visual analogue scale(VAS)score was observed;on 3,6,12 months after surgery,the incidence rate of chronic pain was observed;before surgery,and on 1st,3rd,and 7th days after surgery,the serum levels of tumor necrosis factor(TNF)-α,interleukin(IL)-6 and IL-10 were detected;the number of analgesia pump press,rescue analgesia,and the occurrence of adverse reaction after surgery were recorded in the two groups.Results In the TEAS group,the VAS scores on 1st and 2nd days after surgery,and the incidence rates of chronic pain on 3 and 6 months after surgery were lower than those in the sham TEAS group(P<0.05).On 1st,3rd,and 7th days after surgery,the serum levels of TNF-α,IL-6,and IL-10 were increased compared with those before surgery in both groups(P<0.05,P<0.01);the above indexes in the TEAS group were lower than those in the sham TEAS group(P<0.05).The number of analgesia pump press and the incidence rate of rescue analgesia after surgery in the TEAS group were lower than those in the sham TEAS group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions after surgery between the two groups(P>0.05).Conclusion TEAS can effectively improve both the postoperative acute pain and chronic pain in patients undergoing modified radical mastectomy for breast cancer,the mechanism

关 键 词：乳腺癌 乳腺癌改良根治术 经皮穴位电刺激 术后急性疼痛 术后慢性疼痛 炎性因子 随机对照试验 

分 类 号：R246.5[医药卫生—针灸推拿学]