电针内关对冠心病患者围术期细胞炎性因子的影响

Influence of Electroacupuncture on the Perioperative Inflammatory Cytokines in Patients with Coronary Heart Disease

目的:探讨电针刺激内关穴对冠心病患者围术期细胞炎性因子的影响。方法:选取择期行开腹全子宫及双附件切除术的冠心病患者60例,并将患者随机分为E组(电针组)、C组(对照组),E组用韩式电针刺激仪(HANS-B100B)在麻醉诱导前20 min开始针刺内关穴,并维持针刺至术毕,C组不做任何处理。两组患者分别记录插管前(T0)、插管后即刻(T1)、手术结束时(T2)、拔管后即刻(T3)、拔管后10 min(T4)时的血压(SBP)、平均动脉压(MAP)、心率(HR),并留T0~T4时刻的静脉血,采用酶联免疫吸附法(ELISA)检测血清IL-1β、IL-6、TNF-α的水平。结果:两组患者组内比较:E组各时点SBP、HR、MAP较同组T0时点比较差异无统计学意义(P>0.05),C组T1-T4时点HR、SBP、MAP较同组T0时点明显升高(P<0.05);组间比较:E组T1-T4时HR、SBP、MAP、明显低于C组(P<0.05),E组患者T1~T4静脉血中的IL-1β、IL-6、TNF-α均明显低于C组(P<0.05)。结论:电针刺激内关穴能抑制冠心病患者围术期的炎性反应改善心肌缺血,对心肌的保护作用显著。

Objective： To investigate the effect of electroacupuncture of neiguan on the perioperative inflammatory cytokines levels of patients with coronary heart disease. Methods： 60 cases of patients with coronary heart disease （CHD） underwent elective laparotomy hysterectomy and bilateral salpingo resection operation were selected and randomly divided into the group E （EA group）, group C （control group） and group E with Korean electroacupuncture stimulation instrument （HANS-B 100B） in 20 rain before the induction of anesthesia to acupuncture at Neiguan （PC 6）, and to maintain the acupuncture to postoperative, group C without any treatment. The blood pressure （SBP）, mean arterial pressure （map）, heart rate （HR） of both groups were recorded before intubation （TO）, after intubation immediately （T1）, operation end （T2） and extubation after immediately （T3）, extubation after 10 rain （T4）, and leave a TO - T4 moments of venous blood by enzyme linked immunosorbent method （ELISA） to detect the serum levels of IL-1β, IL-6, TNF-α concentration. Results： The difference between the two groups of patients compared with group E of SBP, MAP, HR is in the same group TO no statistical signif- icance （P〉0.05）, group C T1-T4 point of HR, MAP, SBP than the same group TO increased significantly （P〈0.05）; group compared E T1-T4 Group HR, SBP, MAP significantly lower than in group C （P〈0.05）, E group of patients with T1 - T4 venous blood oflL-1β, IL-6, TNF-α were significantly lower than in group C （P〈0.05）. Conclusion： Electroacuptmcture can inhibit the inflammatory response in patients with coronary heart disease during perioperative period and improve the protective effect of myocardial ischemia.