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[不同频次经皮穴位电刺激联合腕踝针针刺内关穴治疗腹腔镜胆囊切除术后恶心呕吐的疗效观察]

[The curative effect observation of different frequency of TEAS combined with wristband pressing on Neiguan (PC 6) for nausea and vomiting after laparoscopic cholecystectomy].

作者信息

Lu Chao, Du Jun-Ying, Fang Jian-Qiao, Fang Jun-Fan

机构信息

Zhejiang Chinese Medical University, Hangzhou 310053, China; Zhejiang Cancer Hospital, Hangzhou 310022.

Zhejiang Chinese Medical University, Hangzhou 310053, China.

出版信息

Zhongguo Zhen Jiu. 2019 Jan 12;39(1):9-15. doi: 10.13703/j.0255-2930.2019.01.002.

Abstract

OBJECTIVE

To compare the effects of different frequency of transcutaneous electrical acupoint stimulation (TEAS) combined with wristband pressing on Neiguan (PC 6) for nausea and vomiting (PONV) after laparoscopic cholecystectomy, and optimize the TEAS frequency selection for treatment of PONV.

METHODS

Eighty patients undergoing laparoscopic cholecystectomy were randomly divided into a postoperative routine care group, a 2 Hz TEAS combined with wristband pressing group (2 Hz TEAS group), a 100 Hz TEAS combined with combined with wristband pressing group (100 Hz TEAS group) and a 2 Hz/100 Hz TEAS wristband pressing group (2 Hz/100 Hz TEAS group), 20 cases in each group (1 patient dropped off in the postoperative routine care group). All the four groups underwent laparoscopic cholecystectomy, and routine nursing was given after the operation. In the postoperative routine nursing group,only routine nursing was received. In the other three groups, 2 Hz TEAS combined with wristband pressing, 100 Hz TEAS combined with wristband pressing, 2 Hz/100 Hz TEAS combined with wristband pressing to simulate Neiguan (PC 6) were treated on the basis of postoperative routine care after surgery. The treatment was given for 30 min each time for a total of 4 treatments. The incidence of PONV in each group was observed at 0-2 h, 2-8 h, 8-24 h and 24-48 h after operation, and the severity of PONV and postoperative pain were evaluated.

RESULTS

Compared with the postoperative routine care group, the incidence and severity of PONV in the four time periods after surgery were significantly reduced in the 2 Hz/100 Hz TEAS group (all <0.05), the incidence and severity of PONV in patients at 2 h and 2-8 h after surgery were significantly reduced in the 2Hz TEAS group and the 100 Hz TEAS group (all <0.05), the postoperative pain at 8 h and 24 h after surgery was alleviated in the 100 Hz TEAS group and the 2 Hz/100 Hz TEAS group (all <0.05).

CONCLUSION

Different frequency of TEAS combined with wristband pressing to stimulating Neiguan (PC 6) have certain therapeutic effects on PONV in patients undergoing laparoscopic cholecystectomy. 2 Hz/100 Hz TEAS combined with wristband pressing at Neiguan (PC 6) is more effective in PONV. 2 Hz/100 Hz TEAS and 100 Hz TEAS combined with wristband pressing at Neiguan (PC 6) have postoperative analgesic effect, and 2 Hz/100 Hz TEAS has the better analgesic effect.

摘要

目的

比较不同频率经皮穴位电刺激(TEAS)联合腕带按压内关穴(PC 6)对腹腔镜胆囊切除术后恶心呕吐(PONV)的影响,优化治疗PONV的TEAS频率选择。

方法

80例行腹腔镜胆囊切除术的患者随机分为术后常规护理组、2 Hz TEAS联合腕带按压组(2 Hz TEAS组)、100 Hz TEAS联合腕带按压组(100 Hz TEAS组)和2 Hz/100 Hz TEAS腕带按压组(2 Hz/100 Hz TEAS组),每组20例(术后常规护理组有1例患者退出)。四组均行腹腔镜胆囊切除术,术后给予常规护理。术后常规护理组仅接受常规护理。其他三组在术后常规护理基础上,分别采用2 Hz TEAS联合腕带按压、100 Hz TEAS联合腕带按压、2 Hz/100 Hz TEAS联合腕带按压模拟内关穴(PC 6)进行治疗。每次治疗30分钟,共治疗4次。观察各组术后0 - 2小时、2 - 8小时、8 - 24小时和24 - 48小时PONV的发生率,并评估PONV的严重程度和术后疼痛情况。

结果

与术后常规护理组相比,2 Hz/100 Hz TEAS组术后四个时间段PONV的发生率和严重程度均显著降低(均<0.05),2 Hz TEAS组和100 Hz TEAS组患者术后2小时及2 - 8小时PONV的发生率和严重程度显著降低(均<0.05),100 Hz TEAS组和2 Hz/100 Hz TEAS组术后8小时和24小时的疼痛得到缓解(均<0.05)。

结论

不同频率的TEAS联合腕带按压刺激内关穴(PC 6)对腹腔镜胆囊切除术后患者的PONV有一定治疗作用。2 Hz/100 Hz TEAS联合腕带按压内关穴(PC 6)对PONV的疗效更佳。2 Hz/100 Hz TEAS和100 Hz TEAS联合腕带按压内关穴(PC 6)有术后镇痛效果,且2 Hz/100 Hz TEAS的镇痛效果更佳。

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