Ni Yu-Fei, Li Jun, Wang Ben-Fu, Jiang Song-He, Chen Yi, Zhang Wei-Feng, Lian Qing-Quan
Department of Anesthesiology, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, China.
Zhen Ci Yan Jiu. 2009 Oct;34(5):339-43.
To observe the effect of electroacupuncture (EA) on bispectral index (BIS) and plasma beta-endorphin (beta-EP) level in patients undergoing colonoscopy.
Sixty patients were equally randomized into EA group and control group with 30 cases in each. EA (2 Hz/100 Hz, 4-6 V) was applied to the right Zusanli (ST 36) and Shangjuxu (ST 37), and the left Yinlingquan (SP 9), Sanyinjiao (SP 6) and bilateral Hegu (LI 4) respectively 30 min before colonoscopy. The mean arterial pressure (MAP), heart rate (HR) and BIS in two groups were continuously monitored during the study. Plasma beta-EP concentration was detected by radioimmunoassay. The patient's adverse reactions (including pain, satisfaction degree, etc.) were evaluated by visual analog scale (VAS) and verbal stress scale (VSS).
Self-comparison showed that MAP and HR in control group increased significantly during colonoscope's splenic flexure passing (P<0.05). Whereas the 2 indexes in EA group had no significant changes during colonoscope insertion, and its splenic flexure passing, hepatic flexure passing and post-enteroscopy (P>0.05). Comparison between two groups showed that MAP at the time-point of colonoscope insertion, and HR at the time-point of colonoscope's splenic flexure passing in EA group were significantly lower than those in control group (P<0.05). BIS values of EA group were significantly lower than those of control group at different time-points after colonoscope insertion (P<0.01). Plasma beta-EP concentrations at the time-points of colonoscope's hepatic flexure passing and post-enteroscopy were evidently increased in both groups in comparison with pre-enteroscopy (P<0.01), and beta-EP was significantly lower in EA group than that in control group at the time-point of colonoscope's hepatic flexure passing (P<0.05). The dosage of Midazolam used for conscious-sedation and the scores of VAS and VSS were also considerably lower in EA group than those in control group (P<0.05, P<0.01). No significant differences were found between two groups in the adverse reactions as dizziness, nausea, vomiting and abdominal pain, but the patients' satisfaction degree in EA group was evidently higher than that in control group (P<0.05).
Acupuncture analgesia can effectively lower the colonoscopy patients' BIS value and plasma beta-EP level, meaning attenuation of the patients' stress responses during colonoscopy after EA.
观察电针（EA）对结肠镜检查患者脑电双频指数（BIS）及血浆β-内啡肽（β-EP）水平的影响。
将60例患者随机均分为EA组和对照组，每组30例。在结肠镜检查前30分钟，分别对EA组患者右侧足三里（ST 36）、上巨虚（ST 37），左侧阴陵泉（SP 9）、三阴交（SP 6）及双侧合谷（LI 4）施加电针（2Hz/100Hz，4 - 6V）。研究期间持续监测两组患者的平均动脉压（MAP）、心率（HR）及BIS。采用放射免疫法检测血浆β-EP浓度。通过视觉模拟评分法（VAS）和言语应激量表（VSS）评估患者的不良反应（包括疼痛、满意度等）。
自身比较显示，对照组在结肠镜通过脾曲时MAP和HR显著升高（P<0.05）。而EA组在结肠镜插入、通过脾曲、通过肝曲及结肠镜检查后，这两项指标无显著变化（P>0.05）。两组间比较显示，EA组在结肠镜插入时的MAP及在结肠镜通过脾曲时的HR显著低于对照组（P<0.05）。EA组在结肠镜插入后不同时间点的BIS值显著低于对照组（P<0.01）。与结肠镜检查前相比，两组在结肠镜通过肝曲及结肠镜检查后的血浆β-EP浓度均明显升高（P<0.01），且在结肠镜通过肝曲时EA组的β-EP显著低于对照组（P<0.05）。EA组用于清醒镇静的咪达唑仑用量及VAS和VSS评分也显著低于对照组（P<0.05，P<0.01）。两组在头晕、恶心、呕吐及腹痛等不良反应方面无显著差异，但EA组患者的满意度明显高于对照组（P<0.05）。
针刺镇痛可有效降低结肠镜检查患者的BIS值及血浆β-EP水平，表明电针后结肠镜检查期间患者应激反应减轻。
