硬膜外腔吗啡和电针对术后病人T淋巴细胞亚群的影响

EFFECT OF EPIDURAL MORPHINE AND ELECTROACUPUNCTURE(EA)ON T LYMPHOCYTE SUBTYPES OF POSTOPERATIVE PATIENTS

目的：观察吗啡和电针对术后病人免疫功能的影响。方法：研究共分４组：正常对照组１０例（Ａ组）；将１８例Ａ．Ｓ．Ａ．Ⅰ～Ⅱ级择期行单纯胆囊切除术后病人随机分为手术组（Ｂ组），吗啡组（Ｃ组）和吗啡伍用电针组（Ｄ组）。分别于术后第１、３、７ｄ观察吗啡和电针对Ｔ淋巴细胞亚群表达能力的变化。结果：Ｂ组在手术后第１ｄ，ＣＤ３＋和ＣＤ４＋的表达能力有显著抑制（Ｐ＜０．０５）；Ｃ组在硬膜外腔注射吗啡１ｍｇ后，ＣＤ＋３和ＣＤ＋４的表达能力在术后第７ｄ有显著抑制（Ｐ＜０．０５）；Ｄ组吗啡伍用电针后，ＣＤ＋３和ＣＤ＋４的表达能力在术后各个时间与正常对照比较均无显著性变化。结论：硬膜外腔注射吗啡能使术后病人的Ｔ淋巴细胞亚群表达能力下降，电针能改善这种异常变化。

Aim: To study the influences of epidural morphine and EA on CD + 8 and CD + 4 positive lymphocyte subtypes in postoperative pepiod. Methods: Group A was normal control(10 cases). The 18 patients(A.S.A:Ⅰ～Ⅱ) underwent cholesystectomy were randomly divided into group B,C and D. Group B was the operation group. Group C, the morphine group (morphine 1 mg was administered epidurally 1 hour after the last injection of local anesthetic drug into epidural space). Group D,the morphine plus EA group [Acupuncturing HoKu(L.I. 4),NeiKuan(P.6),TsuSanLi(St.36)and San YinChiao(Sp.6) was given continuously for at least 1 hour after giving morphine for 1 hour]. Peripheral blood samples were taken on the lst, 3rd and 7th days after operation. The fluorecently labeled monoclonal antibodies to cell surface antigens of CD + 3 and CD + 4 were incubated with the blood without red cells and analyzed by FACS. Results: The percentage of CD + 3 and CD + 4 cells were decreased in operation group in 1st day and suppressed in morphine group in 7th day after surgery. There was no significant changes in morphine plus EA group. Conclusion: EA can anatagonize the immunosuppression produced by morphine.