Zhang Meng, Zhao Nan, Yang Ge, Zhang Huan-Huan, Li Jian-Li
Department of Anesthesia, Hebei General Hospital, Shijiazhuang 050051, China.
Department of Anesthesia, The Third Hospital of Hebei Medical University, Shijiazhuang 050051.
Zhen Ci Yan Jiu. 2025 Jul 25;50(7):815-821. doi: 10.13702/j.1000-0607.20241107.
To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) at the bilateral acupoints Neiguan (PC6) and Jianshi (PC5) on heart rate variability (HRV) and inflammatory factors in frail elderly patients undergoing laparoscopic colorectal cancer surgery under general anesthesia.
A total of 78 frail elderly patients undergoing elective laparoscopic colorectal cancer surgery were randomized into the TEAS group (39 patients, with 2 patients dropping out) and the control group (39 patients, with 1 patient dropping out). In the TEAS group, TEAS was applied to the bilateral PC6 and PC5 from 30 min before anesthesia induction until the end of the surgery. The control group was connected to an electronic acupuncture instrument at the same acupoints but did not receive electrical stimulation. A short-term Holter electrocardiogram was used to collect HRV parameters in the frequency domain, including low-frequency power (LF), high-frequency power (HF), and the LF/HF ratio. Serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured using ELISA. The Quality of Recovery-15 (Qor-15) score was recorded, along with adverse reactions such as postoperative nausea and vomiting (PONV), palpitations, chest tightness, and chest pain.
Compared with 1 d before surgery, LF and HF were significantly decreased (<0.05), and the LF/HF ratio significantly increased (<0.05) at 1, 2, and 3 d after surgery in the control group. In the TEAS group, both LF and the LF/HF ratio were significantly decreased (<0.05) at 1, 2, and 3 d after surgery. Compared with the control group, LF and HF levels were significantly increased (<0.05), and the LF/HF ratio was significantly decreased (<0.05) in the TEAS group at 1, 2, and 3 d after surgery. Both groups exhibited increased levels of CRP and IL-6 at 1, 3, and 5 d after surgery compared to 1 d before surgery (<0.05), with the TEAS group showing lower CRP and IL-6 levels than the control group (<0.05). Compared to baseline before surgery, the Qor-15 scores of both groups were decreased at 1, 2, and 3 d after surgery (<0.05), with the TEAS group showing significantly higher Qor-15 scores than those in the control group (<0.05). The incidence of PONV, palpitations, chest tightness, and chest pain in the TEAS group was lower than that in the control group (<0.05).
TEAS at the PC6 and PC5 can regulate autonomic nervous function, reduce the early postoperative sympathetic nerve excitation, maintain parasympathetic nerve tension, reduce inflammatory responses, improve the quality of postoperative recovery, and decrease the incidence of postoperative adverse reactions in frail elderly patients after laparoscopic colorectal cancer surgery.
探讨经皮穴位电刺激（TEAS）双侧内关穴（PC6）和间使穴（PC5）对全身麻醉下接受腹腔镜结直肠癌手术的虚弱老年患者心率变异性（HRV）及炎症因子的影响。
将78例择期接受腹腔镜结直肠癌手术的虚弱老年患者随机分为TEAS组（39例，2例退出）和对照组（39例，1例退出）。TEAS组在麻醉诱导前30分钟至手术结束期间对双侧PC6和PC5进行经皮穴位电刺激。对照组在相同穴位连接电子针灸仪但不接受电刺激。采用短期动态心电图收集频域HRV参数，包括低频功率（LF）、高频功率（HF）及LF/HF比值。采用酶联免疫吸附测定法检测血清C反应蛋白（CRP）和白细胞介素-6（IL-6）浓度。记录术后恢复质量-15（Qor-15）评分以及术后恶心呕吐（PONV）、心悸、胸闷和胸痛等不良反应。
与术前1天相比，对照组术后1、2和3天LF和HF显著降低（<0.05），LF/HF比值显著升高（<0.05）。TEAS组术后1、2和3天LF和LF/HF比值均显著降低（<0.05）。与对照组相比，TEAS组术后1、2和3天LF和HF水平显著升高（<0.05），LF/HF比值显著降低（<0.05）。与术前1天相比，两组术后1、3和5天CRP和IL-6水平均升高（<0.05），TEAS组CRP和IL-6水平低于对照组（<0.05）。与术前基线相比，两组术后1、2和三天Qor-15评分均降低（<0.05），TEAS组Qor-15评分显著高于对照组（<0.05）。TEAS组PONV、心悸、胸闷和胸痛的发生率低于对照组（<0.05）。
PC6和PC5穴位的TEAS可调节自主神经功能，减轻术后早期交感神经兴奋，维持副交感神经张力，减轻炎症反应，改善术后恢复质量，降低腹腔镜结直肠癌手术后虚弱老年患者术后不良反应的发生率。
