电针改善硬膜外吗啡用于术后镇痛所引起的免疫抑制

Electroacupuncture Improved Immunosurppression Produced by Epidural Morphine

为观察硬膜外吗啡和电针对术后患者免疫功能的影响，检测自然杀伤细胞（ＮＫｃｅｌｌ）活性和ＰＨＡ诱导白细胞介素２（ＩＬ－２）水平在单纯胆囊切除术患者术前和术后第１、３、７天的动态变化情况。结果吗啡组ＮＫ活性在术后第１、３、７天抑制，手术组仅在术后第１、３天出现抑制，而抑制率低于同天的吗啡组，电针可拮抗吗啡引起的ＮＫ活性抑制加深状况。在术后第１天，手术组和吗啡组ＩＬ－２水平均下降，吗啡＋电针组无明显变化，术后第７天吗啡＋电针组ＩＬ－２升高接近正常人水平。表明电针能改善硬膜外吗啡引起的免疫抑制，促进术后机体的恢复。硬膜外吗啡结合电针是值得推荐的术后镇痛方法。

The influences of epidural morphine and electroacupuncture(EA )on PHAinduced IL-2production and NK cell activity were investigated in 18 patients of cholecystectomy on the time before and lst ,3rd ,7th day after operation, All patients were divided into three groups:operation group;morphine group, injected lmg morphine into epidural space; morphine +EA group,EA of Zusanli,Sanyinjiao,Hegu,Neiguan points were used 1 hour after epidural injection of morphine and lasted 1 hour. Compared with preoperative values,NK cell activity was significantly inhibited in morphine groups on lst,3rd,7th postoperative day,while it was only inhibited in operation group on lst, 3rd postoperative day with a lower suppressive ratio than it of morphine group, EA antagonized this serious immune depression condition caused by morphine,PHA-induced IL-2 production were decreased in both operation and morphine group on lst day after surgery. In morphine+EA group,it was less decreased on lst day and increased to a normal level on 7th day after surgery. These results demonstrated that EA could improve immunosuppression produced by epidural morphine and help patients to recover from surgery. EA combined with epidural morphine might be a better method to relieve clinical postoperative pain.