He Dan, Wang Fu Zhe, Zhang Zhan, Huang Feng, Chen Jiao Jiao, Li Bai
Department of Rehabilitation, Shanghai Changhai Hospital, Shanghai 200433, China.
Zhen Ci Yan Jiu. 2020 Jan 25;45(1):51-6. doi: 10.13702/j.1000-0607.1901256.
To observe the effect of low-frequency electrical acupoint stimulation on gastrointestinal motility in patients undergoing radical gastrectomy, and its impact on regulation of inflammatory response, so as to evaluate its clinical value.
A total of 177 patients undergoing radical gastrectomy were randomly divided into conventional group (＝43), low-frequency electrical acupoint stimulation (LEAS) group (＝45), fast track surgery (FTS) group (＝46) and FTS＋LEAS group (＝43). Patients of the conventional group received conventional treatment (pre-surgical mechanical bowel preparation, post-surgical fasting, and indwelling abdominal drainage tube, etc.). Patients in the LEAS group were treated by low-frequency electrical stimulation at bilateral Zusanli (ST36), Shangjuxu(ST37), Xiajuxu(ST39) and Sanyinjiao(SP6) for 30 min, once daily from 1 day after the operation to first postoperative flatus. FTS group was given fast track surgery treatment, such as preoperative education, preoperative nutritional support, early oral feeding, early removal of abdominal drainage tube, etc. The FTS＋LEAS group was given low-frequency electrical acupoint stimulation on the basis of the FTS treatment. Levels of white blood cells (WBC), neutrophils (N), C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) at 1, 3, and 6 d after the operation in the 4 groups were assayed. The first postoperative flatus and defecation time were recorded.
After the treatment, the first postoperative flatus and defecation time in the LEAS, FTS and FTS＋LEAS groups were significantly shorter than those of the conventional group (<0.05), and the first flatus time of the FTS＋LEAS group was even earlier than that of the FTS group (<0.05). No significant differences were found among the 3 groups in the postoperative defecation time (>0.05). The CRP levels in the 4 groups on 3 and 6 d after operation were higher than those on the 1st postoperative day, and the highest level was on 3 d after the operation. Compared with the conventional group, CRP level on 3 d and CRP and IL-6 levels on 3 and 6 d in the LEAS and FTS＋LEAS groups were significantly lower (<0.05). Compared with the LEAS group, the levels of N, CRP on 3 d and the levels of N, CRP, IL-6 on 6 d in the FTS group were significantly increased (<0.05). Compared with the FTS group, the level of CRP on 3 d and the levels of N, CRP, IL-6 on 6 d in the FTS＋LEAS group were significantly decreased (<0.05).
FTS combined with LEAS is superior to simple FTS or LEAS treatment in shortening the first flatus and defecation time and promoting the recovery of gastrointestinal motility function in patients undergoing radical gastrectomy, which may be associated with its effect in alleviating postoperative inflammatory responses.
观察低频电穴位刺激对胃癌根治术患者胃肠动力的影响及其对炎症反应调节的作用，以评估其临床价值。
将177例行胃癌根治术的患者随机分为常规组（n＝43）、低频电穴位刺激（LEAS）组（n＝45）、快速康复外科（FTS）组（n＝46）和FTS＋LEAS组（n＝43）。常规组患者接受常规治疗（术前机械性肠道准备、术后禁食、留置腹腔引流管等）。LEAS组患者于术后第1天至首次排气期间，每天对双侧足三里（ST36）、上巨虚（ST37）、下巨虚（ST39）和三阴交（SP6）进行低频电刺激30分钟。FTS组给予快速康复外科治疗，如术前教育、术前营养支持、早期经口进食、早期拔除腹腔引流管等。FTS＋LEAS组在FTS治疗基础上给予低频电穴位刺激。检测4组患者术后1、3、6天的白细胞（WBC）、中性粒细胞（N）、C反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平。记录术后首次排气和排便时间。
治疗后，LEAS组、FTS组和FTS＋LEAS组术后首次排气和排便时间均显著短于常规组（P＜0.05），且FTS＋LEAS组首次排气时间早于FTS组（P＜0.05）。3组术后排便时间比较，差异无统计学意义（P＞0.05）。4组患者术后3、6天的CRP水平均高于术后第1天，且术后3天最高。与常规组比较，LEAS组和FTS＋LEAS组术后3天的CRP水平及术后3、6天的CRP和IL-6水平均显著降低（P＜0.05）。与LEAS组比较，FTS组术后3天的N、CRP水平及术后6天的N、CRP、IL-6水平均显著升高（P＜0.05）。与FTS组比较，FTS＋LEAS组术后3天的CRP水平及术后6天的N、CRP、IL-6水平均显著降低（P＜0.05）。
FTS联合LEAS在缩短胃癌根治术患者首次排气和排便时间、促进胃肠动力功能恢复方面优于单纯FTS或LEAS治疗，这可能与其减轻术后炎症反应的作用有关。
