针灸治疗术后恶心呕吐概况

An Overview Of Acupuncture Treatment Of Postoperative Nausea And Vomiting

术后恶心呕吐（PONV）对患者生理及心理都有影响,既延长住院天数,又增加治疗费用,尤其是肥胖、吸烟、腹腔镜手术等危险因素,发生率明显高于一般患者;药物治疗效果不佳,且有副作用,依从性差,非药物治疗成为新选择。针灸可刺激机体免疫功能,反馈至大脑呕吐中枢;促使内啡肽释放止吐;也可通过神经-内分泌系统调节,影响5-HT3转运;针刺时大脑中枢特定区域会发生相应神经系统改变;增强迷走神经调节作用。术前、术中持续刺激穴位获得满意疗效均有报告,尚未形成统一认识,有近部选穴,远部选穴,辨证选穴,配穴按经脉（本经、表里经、同名经）、按部位（上下、前后、左右）,考虑手术因素,多选择四肢部位相关联穴位,常用内关、足三里、三阴交。＂刺之要,气至而有效＂＂得气＂可激活大脑皮质A10神经分布领域,激活旧皮质同时也激发新皮质活性,对脑细胞有广泛影响。留针时间长短与针刺部位、病情、体质、疾病相关,一般留针10~20min。

Postoperative nausea and vomiting（PONV） have influence on patient＇s physical and psychological. PONY not only extended hospitalization days, but also increase the cost of treatment. It has a higher incidence especially in patients with risk factors such as obesity, smoking, laparoscopic surgery. As the drug treatment effect of PONY is not good, the non-drug therapy has became the new choice. Acupuncture can stimulate the body＇s immune function, feed back it to the brain vomiting center and promote endorphins released anti-nausea. Acupuncture also has the regulating effect through the nerve-endocrine system, the influence of 5-HT3 transport; When acupuncture brain center corresponding neurological changes will happen in a particular area and enhance the vagus nerve. Preoperative and intraoperative continued to stimulate acupuncture points are reporting a satisfactory curative effect, has not yet form a unified understanding, nearly choose acupuncture point, far selected point, dialectical choose acupuncture point, with acupuncture point according to the meridian（the classics, table, the same name）, according to the parts（top and bottom, before and after, left and right）. Considering the surgery factor, we choose more limb parts associated meridians, such as Neiguan（内关）,Tsusanli（足三里）,Sanyinjiao（三阴交）.＂Acupuncture related points,Acuesthesia can have the effective＂＂Acuesthesia＂（得气） can activate the cerebral cortex nerve A10 distribution areas, activate paleocortexand inspire new cortical activity, has a broad effect on brain cells.Time of retaining needle is related on the needle position, illness, constitution, disease, the general time of retaining needle is 10~20 min.