经皮穴位电刺激对腹腔镜肠道手术围手术期炎症反应及肠道通透性的影响

[Transcutaneous electrical acupoint stimulation on inflammatory response and intestinal permeability in perioperative period of laparoscopic intestinal surgery].

作者信息

Guo Jun, Tang Wei, Guo Feng, Yang Liming, Wang Jian, Fu Guoqiang, Yuan Lan

机构信息

Department of Anesthesiology, Shuguang Hospital, Affiliated to Shanghai University of TCM, Shanghai 201203, China.

出版信息

Zhongguo Zhen Jiu. 2018 Oct 12;38(10):1043-6. doi: 10.13703/j.0255-2930.2018.10.004.

Abstract

OBJECTIVE

To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on the inflammatory response and intestinal permeability after laparoscopic radical surgery for colon cancer, so as to explore the protective mechanism for perioperative organs.

METHODS

Sixty patients with laparoscopic intestinal resection were randomly assigned into an observation group and a control group, 30 cases in each group. TEAS at Zusanli (ST 36), Neiguan (PC 6) and Hegu (LI 4) was used in the observation group on the day of operation and within 3 days after surgery, 2 Hz, within 2 mA. The interventions in the control group were the same as those in the observation group, except opening the current source. Central venous blood was collected before TEAS and 12 h, 24 h, 48 h, 72 h after surgery. The level of the inflammatory indexes of tumor necrosis factor-α(TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6) and intestinal mucosal barrier response indexes of endotoxin (LPS) and D-lactate were detected.

RESULTS

Compared with the control group, the levels of IL-1, IL-6 and TNF-α decreased in the observation group 24 h, 48 h and 72 h after surgery (all <0.05). The concentrations of D-lactate and LPS were not statistically different between the two groups (both >0.05).

CONCLUSION

TEAS can reduce the inflammatory reaction after laparoscopic radical surgery for colon cancer, but has no effect on the intestinal permeability.

摘要

目的

观察经皮穴位电刺激(TEAS)对结肠癌腹腔镜根治术后炎症反应及肠通透性的影响,以探讨其对围手术期器官的保护机制。

方法

将60例行腹腔镜肠切除术的患者随机分为观察组和对照组,每组30例。观察组于手术当天及术后3天内对足三里(ST 36)、内关(PC 6)和合谷(LI 4)进行经皮穴位电刺激,频率2 Hz,电流强度2 mA以内。对照组除不开启电流源外,干预措施同观察组。于经皮穴位电刺激前及术后12 h、24 h、48 h、72 h采集中心静脉血,检测肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)等炎症指标水平及内毒素(LPS)、D-乳酸等肠黏膜屏障反应指标。

结果

与对照组比较,观察组术后24 h、48 h、72 h时IL-1、IL-6及TNF-α水平降低(均P<0.05)。两组D-乳酸及LPS浓度比较,差异无统计学意义(均P>0.05)。

结论

经皮穴位电刺激可减轻结肠癌腹腔镜根治术后的炎症反应,但对肠通透性无影响。

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