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电针与穴位注射对术后早期炎性肠梗阻患者血浆促炎细胞因子及胃动素表达的影响

[Effect of electroacupuncture and acupoint injection on expression of plasma proinflammatory cytokines and motilin for patients with early postoperative inflammatory intestinal obstruction].

作者信息

Shen Li-Ping, Lei Chun-Hua, Ding Kai-Yun

机构信息

Acupuncture-Moxibustion Department of Subei People's Hospital, Yangzhou 225001, Jiangsu Province, China.

出版信息

Zhongguo Zhen Jiu. 2011 Sep;31(9):795-8.

Abstract

OBJECTIVE

To verify the efficacy of electroacupuncture (EA) and acupoint injection on early postoperative intestinal obstruction and explore its mechanism.

METHODS

One hundred and sixteen cases were divided randomly into two groups. In control group (56 cases), the conventional western medicine was applied, including gastrointestinal decompression, parenteral nutrition (PN), anti-inflammation and supporting therapy. In observation group (60 cases), on the basis of the treatment as control group, EA and acupoint injection with Neostigmine were supplemented. Zusanli (ST 36), Shangjuxu (ST 37)/Xiajuxu (ST 39) and Dachangshu (BL 25) were selected as main points. Before treatment and after 3 days treatment, the levels of plasma interleukint (IL-6), tumor necrosis factor-alpha (TNF-alpha) and motilin (MOT) were determined.

RESULTS

In observation group, the mean recovery time of bowel sound and the mean frequency of passing gas were less than those in control group (both P < 0.01). After treatment, in either group, the levels of IL-6 and TNF-alpha were down-regulated as compared with those before treatment (all P < 0.01). After treatment, in observation group, IL-6 level was (15.2 +/- 4.1) pg/mL and TNF-alpha level was (18.3 +/- 6.5) pg/mL. They were (35.5 +/- 7.2) pg/mL and (52.7 +/- 12.3) pg/mL respectively in control group, indicating significant difference in statistics between two groups (both P < 0.01). In either group, MOT level increased after treatment as compared with that before treatment (both P < 0 01). After treatment, in observation group, the increase of MOT level was superior to that in control group [(190.7 +/- 48. 5 ) pg/mL vs (114.6 +/- 36.9) pg/mL, P < 0.01].

CONCLUSION

Electroacupuncture and acupoint injection are significantly effective in the treatment of early postoperative intestinal obstruction. This therapy may inhibit the release of inflammatory factors to reduce intestinal wall edema and it may promote MOT secretion to increase intestinal peristalsis. As a result, the recovery of gastrointestinal function is promoted.

摘要

目的

验证电针(EA)及穴位注射治疗术后早期肠梗阻的疗效并探讨其作用机制。

方法

116例患者随机分为两组。对照组(56例)采用西医常规治疗,包括胃肠减压、肠外营养(PN)、抗炎及支持治疗。观察组(60例)在对照组治疗基础上,加用电针及新斯的明穴位注射。选取足三里(ST36)、上巨虚(ST37)/下巨虚(ST39)及大肠俞(BL25)为主穴。治疗前及治疗3天后,测定血浆白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及胃动素(MOT)水平。

结果

观察组肠鸣音平均恢复时间及平均排气次数均少于对照组(均P<0.01)。治疗后,两组IL-6及TNF-α水平均较治疗前下调(均P<0.01)。治疗后,观察组IL-6水平为(15.2±4.1)pg/mL,TNF-α水平为(18.3±6.5)pg/mL;对照组分别为(35.5±7.2)pg/mL及(52.7±12.3)pg/mL,两组比较差异有统计学意义(均P<0.01)。两组治疗后MOT水平均较治疗前升高(均P<0.01)。治疗后,观察组MOT水平升高幅度优于对照组[(190.7±48.5)pg/mL比(114.6±36.9)pg/mL,P<0.01]。

结论

电针及穴位注射治疗术后早期肠梗阻疗效显著。该疗法可能通过抑制炎症因子释放减轻肠壁水肿,促进MOT分泌增加肠道蠕动,从而促进胃肠功能恢复。

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