经皮电刺激天突穴对舒芬太尼诱发呛咳反应的影响:一项多中心、随机、对照临床研究  

Effect of transcutaneous electrical acupoint stimulation at Tiantu on sufentanil-induced cough:a multi-center,randomized,controlled clinical study

作　　者：朱建坡[1] 王洋 任伟东 李梦杰 王兢燕 周建华 张虎 袁峰[3] 张新科 吕志峰[1] Zhu Jianpo;Wang Yang;Ren Weidong;Li Mengjie;Wang Jingyan;Zhou Jianhua;Zhang Hu;Yuan Feng;Zhang Xinke;Lyu Zhifeng(Department of Anesthesiology,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;First Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;Department of Anesthesiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Anesthesiology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南中医药大学第一附属医院麻醉科,郑州450000 [2]河南中医药大学第一临床医学院,郑州450000 [3]郑州大学第二附属医院麻醉科,郑州450000 [4]南阳中心医院麻醉科,南阳473000

出　　处：《中国实用医刊》2025年第4期14-18,共5页Chinese Journal of Practical Medicine

基　　金：2020年中国博士后科学基金新冠肺炎疫情防控专项资助(面上资助)项目(2020M670025ZX);2021年河南省中医药科学研究专项课题项目(20-21ZY21970)。

摘　　要：目的探讨术前经皮穴位电刺激(TEAS)天突穴对舒芬太尼诱发呛咳反应(SIC)的影响。方法前瞻性抽取2020年11月至2021年12月就诊于河南中医药大学第一附属医院、郑州大学第二附属医院和南阳中心医院的170例手术患者作为研究对象,按随机数字表法分为对照组和TEAS组,每组85例。术前患者行TEAS天突穴30 min,疏密波,频率为2/10 Hz,对照组强度为患者感受最小电流强度减1,TEAS组刺激强度为患者最大耐受电流强度减1。麻醉诱导静脉推注舒芬太尼0.3μg/kg,10μg/mL,2 s内推完,观察1 min,主要指标为患者给药后1 min内呛咳情况,次要指标为无创血压、心率、血氧饱和度及不良反应。结果TEAS组SIC发生率(30.00%,24/80)低于对照组(42.50%,34/80),但差异未见统计学意义(P=0.064);对照组呛咳Ⅱ级、Ⅲ级发生率为16.25%(13/80)、8.75%(7/80),高于TEAS组的7.50%(6/80)、5.00%(4/80);两组其他不良反应发生率比较差异未见统计学意义(P>0.05)。结论TEAS天突穴30 min可有助于减轻SIC程度,预防术后恶心、咽喉痛等不良反应,维持血流动力学稳定,可作为一种临床补充疗法预防SIC。ObjectiveTo investigate the effect of preoperative transcutaneous electrical acupoint stimulation(TEAS)at Tiantu on sufentanil-induced cough(SIC).MethodsA total of 170 patients treated by surgery were prospectively selected from the First Affiliated Hospital of Henan University of Chinese Medicine,the Second Affiliated Hospital of Zhengzhou University and Nanyang Central Hospital between November 2020 to December 2021;and they were divided into a control group and a TEAS group using a random number table method,with 85 cases in each group.Before surgery,patients underwent TEAS at Tiantu for 30 minutes,with a frequency of 2/10 Hz and a sparse-dense wave.The intensity in the control group was set at the minimum current intensity felt by the patient minus 1;the intensity in the TEAS group was set at the maximum tolerable current intensity felt by the patient minus 1.Anesthesia induction involved intravenous administration of sufentanil at a dose of 0.3μg/kg,10μg/mL,within 2 seconds.Patients were observed for 1 minute,with the occurrence of coughing within 1 minute after drug administration as the primary indicator,and non-invasive blood pressure,heart rate,blood oxygen saturation,and adverse reactions as the secondary indicators.ResultsThe incidence of SIC in the TEAS group(30.00%,24/80)was lower than that in the control group(42.50%,34/80),but the difference was not statistically significant(P=0.064).The incidence of gradeⅡcoughing and gradeⅢcoughing in the control group were 16.25%(13/80)and 8.75%(7/80),respectively,higher than the 7.50%(6/80)and 5.00%(4/80)in the TEAS group.There was no statistically significant difference in the incidence of other adverse reactions between the two groups(P>0.05).ConclusionsThirty minutes of TEAS at Tiantu can help reduce the severity of SIC,prevent postoperative adverse reactions,such as nausea and sore throat,and maintain hemodynamic stability,serving as a clinical complementary therapy to prevent SIC.

关 键 词：舒芬太尼 呛咳 经皮穴位电刺激 天突穴 预处理 

分 类 号：R614[医药卫生—麻醉学]