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[电针治疗缓解胃肠道手术患者应激反应的临床试验]

[Clinical Trial of Electroacupuncture Treatment for Relieving Stress Responses in Patients Undergoing Gastrointestinal Surgery].

作者信息

Geng Yan-Xia, Chen Dong, Zhou Hai-Qi, Cheng Lu, Pei Ying-Hao, Chen Qiu-Hua, Diao Ren-Zheng

机构信息

Intensive Care Unit, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.

Department of Acupuncture-moxibustion and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.

出版信息

Zhen Ci Yan Jiu. 2018 Dec 25;43(12):793-6. doi: 10.13702/j.1000-0607.170617.

Abstract

OBJECTIVE

To observe the therapeutic effect of electroacupuncture (EA) at Zusanli (ST 36) and Neiguan (PC 6) on stress responses of patients undergoing gastrointestinal surgery.

METHODS

A total of 40 patients undergoing gastrointestinal surgery were randomized into conventional treatment group (control) and EA group (=20 in each group). Patients of the EA group received conventional treatment (pre- and post-surgical fasting, measures for gastrointestinal decompression, parenteral nutrition support, and patient controlled analgesia pump, etc.) and EA stimulation (2 Hz, 30 min) of bilateral ST 36 and PC 6 (twice after surgery, at an interval of 6 h), and patients of the control group received conventional treatment only. The visual analogue scale (VAS) score was used to assess the patients' pain severity and the blood glucose levels were detected once every 4-6 h within 24 h after operation. Serum cortisol (Cort) and adrenocorticotropic hormone (ACTH) levels were detected by chemiluminescence method, and serum D-lactic acid level (for assessing gastrointestinal mucosal injury) was assayed by ELISA.

RESULTS

After the treatment, the levels of serum Cort, ACTH, D-lactate acid and the highest blood glucose were significantly lower in the EA group than those in the control group (<0.05, <0.01), suggesting a reduction of stress reactions after EA. But no significant difference was found between the control and EA groups in the VAS score (>0.05).

CONCLUSION

EA at ST 36 and PC 6 can alleviate stress responses and reduce intestinal mucosal damage in patients undergoing gastrointestinal surgery.

摘要

目的

观察电针足三里(ST 36)和内关(PC 6)对胃肠道手术患者应激反应的治疗效果。

方法

将40例胃肠道手术患者随机分为常规治疗组(对照组)和电针组(每组20例)。电针组患者接受常规治疗(手术前后禁食、胃肠减压措施、肠外营养支持和患者自控镇痛泵等)以及双侧ST 36和PC 6的电针刺激(2 Hz,30分钟)(术后两次,间隔6小时),对照组患者仅接受常规治疗。采用视觉模拟评分法(VAS)评估患者疼痛程度,术后24小时内每4 - 6小时检测一次血糖水平。采用化学发光法检测血清皮质醇(Cort)和促肾上腺皮质激素(ACTH)水平,采用酶联免疫吸附测定法检测血清D - 乳酸水平(用于评估胃肠道黏膜损伤)。

结果

治疗后,电针组血清Cort、ACTH、D - 乳酸水平及最高血糖水平均显著低于对照组(<0.05,<0.01),提示电针后应激反应减轻。但对照组和电针组VAS评分差异无统计学意义(>0.05)。

结论

电针ST 36和PC 6可减轻胃肠道手术患者的应激反应,减少肠黏膜损伤。

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