Xu Lu-Lu, Zhao Wen-Sheng, Li Lang-Ping, Du Xin-Dan
Department of Pain Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hang Zhou 310003, China.
Department of Anesthesiology, Ruijin Hospital /Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai 200020, China.
J Clin Tuberc Other Mycobact Dis. 2022 Jan 7;27:100298. doi: 10.1016/j.jctube.2022.100298. eCollection 2022 May.
This study aimed to analyze the effects of transcutaneous electrical acupoint stimulation (TEAS) on the immune function in patients with pulmonary tuberculosis (PT) and the inflammatory response following one-lung ventilation surgery by comparing the levels of inflammatory mediators, such as tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and interleukin 8 (IL-8); T lymphocyte subsets, including CD3, CD4, CD8, and CD4/CD8 cells; and natural killer cells (NK cells).
We randomly divided 62 patients who underwent general anesthesia for thoracotomy into two groups: TEAS and sham TEAS. Patients in the TEAS group underwent bilateral acupoint electrical stimulation at the HouXi, ZhiGou, NeiGuan, and HeGu acupoints from 30 min before anesthesia induction until the end of surgery. TEAS was continuously maintained throughout the procedure with a dilatational wave at 2/100 Hz. Those in the sham TEAS group underwent the same management but without stimulation, and the anesthesia induction and maintenance methods were the same in both groups. Venous blood was drawn to monitor inflammatory mediators and lymphocyte subsets before anesthesia induction and 5 days after the surgery.
There was no statistical difference in the general conditions between the two groups ( > 0.05). Before anesthesia induction, the levels of inflammatory factors (IL-6, IL-8, and TNF-α), lymphocyte subsets (CD3, CD4, and CD4/CD8), and NK cells did not statistically differ between the two groups ( > 0.05). Compared to the sham TEAS group, the levels of IL-6, IL-8, TNF-α, and CD8 were lower in the TEAS group, while those of CD3, CD4, CD4/CD8, and NK cells were higher; however, only the change in TNF-α was significant ( < 0.05).
TEAS at the HouXi, ZhiGou, NeiGuan, and HeGu acupoints at 2 Hz/100 Hz can reduce the inflammatory response during one-lung ventilation but has no significant effect on the immune function in patients with tuberculosis.
本研究旨在通过比较肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和白细胞介素8（IL-8）等炎症介质水平；T淋巴细胞亚群，包括CD3、CD4、CD8和CD4/CD8细胞；以及自然杀伤细胞（NK细胞），分析经皮穴位电刺激（TEAS）对肺结核（PT）患者免疫功能及单肺通气手术后炎症反应的影响。
我们将62例行开胸手术全身麻醉的患者随机分为两组：TEAS组和假TEAS组。TEAS组患者在麻醉诱导前30分钟至手术结束期间，在双侧后溪、支沟、内关和合谷穴位进行穴位电刺激。整个过程中以2/100Hz的疏密波持续进行TEAS。假TEAS组患者接受相同管理但不进行刺激，两组的麻醉诱导和维持方法相同。在麻醉诱导前及术后5天抽取静脉血监测炎症介质和淋巴细胞亚群。
两组一般情况无统计学差异（P>0.05）。麻醉诱导前，两组炎症因子（IL-6、IL-8和TNF-α）、淋巴细胞亚群（CD3、CD4和CD4/CD8）及NK细胞水平无统计学差异（P>0.05）。与假TEAS组相比，TEAS组IL-6、IL-8、TNF-α和CD8水平较低，而CD3、CD4、CD4/CD8和NK细胞水平较高；然而，仅TNF-α的变化具有显著性（P<0.05）。
以2Hz/100Hz频率在双侧后溪、支沟、内关和合谷穴位进行TEAS可减轻单肺通气期间的炎症反应，但对肺结核患者的免疫功能无显著影响。
