电针对肺癌术后肺炎及心肺功能的影响  

Effect of electroacupuncture on pneumonia and cardiopulmonary function after lung cancer surgery

作　　者：王翔锋[1] 黄建斌[1] 林树英[1] 李紫嫣 罗颖 林芩[1] WANG Xiangfeng;HUANG Jianbin;LIN Shuying;LI Ziyan;LUO Ying;LIN Qin(The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院,福州350004

出　　处：《上海针灸杂志》2025年第4期434-439,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家中医临床研究基地专项科研课题(JDZX201926)。

摘　　要：目的 观察电针对肺癌手术患者术后早期肺炎及肺功能的影响。方法 选择68例肺癌患者,实施全身麻醉胸腔镜下肺癌根治术,随机分为对照组和观察组,每组34例。对照组进行静吸复合麻醉,观察组在对照组麻醉方法基础上另于麻醉诱导前30 min至手术结束进行电针干预。观察两组术前(T0)、手术结束(T1)、术后24 h(T2)和术后72 h(T3)的血气分析指标[动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))氧合指数(PaO_(2)/FiO_(2))]、血清炎症指标[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6, IL-6)和降钙素原(procalcitonin, PCT)]、白细胞计数(white blood cell count, WBC)以及心肺功能指标[呼气峰流速(peak expiratory flow, PEF)和6分钟步行距离(6-minute walk distance,6MWD)]的变化,比较两组术后肺炎、疼痛及其他并发症的发生情况。结果 与T0比较,两组T1和T2时PaO_(2)、PaO_(2)/FiO_(2)均下降(P<0.05),两组T1时PaCO_(2)均升高(P<0.05),两组T1、T2和T3时血清TNF-α、IL-6和PCT水平及WBC均升高(P<0.05),两组T2、T3时PEF和6MWD均降低(P<0.05)。T2时,观察组PaO_(2)、PaO_(2)/FiO_(2)高于对照组(P<0.05);T1和T2时,观察组血清TNF-α、IL-6和PCT水平及WBC低于对照组(P<0.05);T2和T3时,观察组PEF和6MWD高于对照组(P<0.05);T2时,观察组术后肺炎和恶心呕吐的发生率低于对照组(P<0.05),观察组疼痛视觉模拟量表(visual analog scale, VAS)评分低于对照组(P<0.05)。结论 电针通过减轻术后早期炎症反应和疼痛,改善术后肺功能障碍,加速术后早期肺康复。Objective To observe the effects of electroacupuncture on pneumonia and cardiopulmonary function in patients in the early stage after receiving surgery for lung cancer.Method Sixty-eight patients with lung cancer who received thoracoscopic radical resection of lung cancer under general anesthesia were selected and randomized into a control group and an observation group,with 34 cases in each group.The control group received the combined intravenous and inhalation anesthesia,and the observation group additionally received electroacupuncture beginning 30 min before the induction of anesthesia till the end of the operation.Before the operation(T0),at the end of the operation(T1),at postoperative 24 h(T2),and at postoperative 72 h(T3),the two groups were observed for changes in blood gas analysis parameters[PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)],serum inflammatory indicators[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and procalcitonin(PCT)],white blood cell count(WBC),and cardiopulmonary function indexes[peak expiratory flow(PEF)and 6-minute walk distance(6MWD)].The two groups were also compared in the incidence of postoperative pneumonia,pain,and other complications.Result Compared to T0,both groups showed decreased PaO_(2) and PaO_(2)/FiO_(2) at T1 and T2(P<0.05)and increased PaCO_(2) at T1(P<0.05);the two groups demonstrated increases in the serum levels of TNF-α,IL-6,and PCT as well as WBC at T1,T2,and T3(P<0.05)and decreases in the PEF and 6MWD at T2 and T3(P<0.05).At T2,the observation group was higher than the control group in comparing PaO_(2) and PaO_(2)/FiO_(2)(P<0.05);at T1 and T2,the serum levels of TNF-α,IL-6,and PCT and WBC were lower in the observation group than in the control group(P<0.05);at T2 and T3,the observation group had higher PEF and 6MWD than the control group(P<0.05);at T2,the incidence rates of postoperative pneumonia and nausea and vomiting were lower in the observation group than in the control group(P<0.05),and the observation group had a lower visual analog scale(VAS)score

关 键 词：针刺疗法 电针 疼痛 术后 肺癌 炎症因子 肺功能 术后肺炎 

分 类 号：R246.5[医药卫生—针灸推拿学]