Guan Junjie, Ge Miaomiao, Cai Yuling, Wang Ting, Jiang Zhiwei, Sun Jianhua, Wang Gang
Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210009, China.
Department of Acupuncture and Moxibustion, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210009, China.
Zhongguo Zhen Jiu. 2025 Jun 12;45(6):751-756. doi: 10.13703/j.0255-2930.20240618-k0003. Epub 2025 Mar 19.
To observe the effect of electroacupuncture combined with enhanced recovery after surgery (ERAS) protocol on promoting intestinal function in patients after gastric cancer surgery.
Forty-four patients who underwent radical gastrectomy for gastric cancer were randomly divided into an experimental group (22 cases, 3 cases were excluded) and a control group (22 cases, 4 cases were excluded). Both groups received treatment under ERAS protocol, the experimental group was given electroacupuncture at bilateral Neiguan (PC6), Hegu (LI4), Zusanli (ST36) and Quchi (LI11), disperse-dense wave was selected, with frequency of 2 Hz/100 Hz. The control group received placebo electroacupuncture intervention, with the same acupoints as the experimental group, electrode pads were placed on the acupoints without electrical stimulation. Each session lasted 30 min, starting from 1 h after surgery, once every 24 h, until the patient resumed anal flatus. The intestinal sound rate of both groups was observed 24 h before surgery and 24, 48 h after surgery. The bowel sound recovery time (BSRT), time to first anal flatus, time to first defecation, and tolerance to oral enteral nutrition suspension were compared between the two groups. The levels of serum C-reactive protein (CRP), interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, IL-17, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured 24 h before surgery and 24 h after surgery in both groups.
The intestinal sound rate 24 h after surgery was decreased compared with that 24 h before surgery in the two groups (<0.05), the intestinal sound rate 24, 48 h after surgery in the experimental group was higher than that in the control group (<0.05). The BSRT in the experimental group was earlier than that in the control group (<0.05) .The levels of serum CRP, IL-6, IL-10 24 h after surgery in the experimental group were higher than those 24 h before surgery (<0.05), while the levels of serum CRP, IL-4, IL-6, IL-10, IFN-γ in the control group were higher than those 24 h before surgery (<0.05); the levels of serum CRP、IL-4、IFN-γ 24 h after surgery in the experimental group were lower than those in the control group (<0.05) .The tolerance rate of oral enteral nutrition suspension in the experimental group was 84.2% (16/19), which was higher than 50.0% (9/18) in the control group (<0.05).
Electroacupuncture combined with ERAS protocol can improve the intestinal motility, shorten the BSRT, enhance the tolerance of oral intake, and reduce inflammatory response in patients after gastric cancer surgery.
观察电针联合加速康复外科（ERAS）方案对促进胃癌术后患者肠道功能的影响。
44例行胃癌根治术的患者随机分为实验组（22例，排除3例）和对照组（22例，排除4例）。两组均在ERAS方案下接受治疗，实验组于双侧内关（PC6）、合谷（LI4）、足三里（ST36）和曲池（LI11）行电针治疗，选用疏密波，频率为2Hz/100Hz。对照组接受假电针干预，穴位与实验组相同，电极片置于穴位上但无电刺激。每次治疗持续30分钟，从术后1小时开始，每24小时1次，直至患者恢复肛门排气。观察两组术前24小时及术后24、48小时的肠鸣音率。比较两组的肠鸣音恢复时间（BSRT）、首次肛门排气时间、首次排便时间及口服肠内营养混悬液的耐受性。检测两组术前24小时及术后24小时血清C反应蛋白（CRP）、白细胞介素（IL）-2、IL-4、IL-6、IL-10、IL-12、IL-17、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）水平。
两组术后24小时的肠鸣音率均低于术前24小时（<0.05），实验组术后24、48小时的肠鸣音率高于对照组（<0.05）。实验组的BSRT早于对照组（<0.05）。实验组术后24小时血清CRP、IL-6、IL-10水平高于术前24小时（<0.05），而对照组术后24小时血清CRP、IL-4、IL-6、IL-10、IFN-γ水平高于术前24小时（<0.05）；实验组术后24小时血清CRP、IL-4、IFN-γ水平低于对照组（<0.05）。实验组口服肠内营养混悬液的耐受率为84.2%（16/19），高于对照组的50.0%（9/18）（<0.05）。
电针联合ERAS方案可改善胃癌术后患者的肠道动力，缩短BSRT，增强口服摄入耐受性，减轻炎症反应。
