电刺激双侧足三里对分娩后孕妇胃肠功能恢复的影响及机制研究

Effect of Electrical Stimulation at Bilateral Zusanli on Recovery of Gastrointestinal Function in Pregnant Women after Delivery and Its Mechanism

目的:考察电刺激双侧足三里对分娩后孕妇胃肠功能恢复的影响及可能的机制。方法:选择2016年1月—2017年1月医院妇产科行剖腹产的产妇80例,患者被随机分为对照组和实验组,每组40例。对照组接受术后常规治疗,实验组接受术后常规治疗+双侧足三里电刺激。检测患者肠鸣音恢复正常时间、首次肛口排气时间、首次排便时间、腹痛评分、腹胀评分、胃肠功能时间、胃动素、胃泌素和内皮素。结果:治疗后,实验组肠鸣音恢复时间、首次排气时间和首次排便时间显著低于对照组(t=2.87,P<0.01;t=3.12,P<0.01;t=3.52,P<0.01);实验组48 h恢复正常数显著高于对照组(χ~2=4.02,P<0.05);实验组腹痛评分显著低于对照组(t=5.70,P<0.01);实验组腹涨评分显著高于对照组(t=5.69,P<0.01);实验组胃动素和胃泌素显著高于对照组(t=5.70,P<0.01;t=20.89,P<0.01);实验组内皮素显著低于对照组(t=8.43,P<0.01)。结论:电刺激双侧足三里能促进分娩后孕妇胃肠功能的恢复,降低腹胀和腹痛的发生率,其作用机制可能和增加血清胃动素和胃泌素,减少内皮素有关。

Objective:To investigate the effect of electrical stimulation at bilateral Zusanli(ST36)on the recovery of gastrointestinal function and the possible mechanism after delivery.Methods:Eighty cases of cesarean section from January 2016 to January 2017 in our obstetrics and gynecology department were selected and randomly divided into control group and experimental group,40 cases in each group.The control group received routine postoperative treatment and the experimental group received routine postoperative treatment and electrical stimulation at bilateral Zusanli(ST36).We detected the recovery time of normal bowel sounds,the first anal vent time,the first defecation time,the abdominal pain score,the abdominal distention score,the gastrointestinal function time,the motilin,gastrin and endothelin were measured.Results:After treatment,the recovery time of normal bowel sounds,the first exhaust time and the first defecation time in the experimental group were significantly lower than those of the control group(t=2.87,P<0.01;t=3.12,P<0.01;t=3.52,P<0.01).The number of 48 h returned to normal in the experimental group was significantly higher than that in the control group(χ^2=4.02,P<0.05).The abdominal pain score in the experimental group was significantly lower than that in the control group(t=5.70,P<0.01).The abdominal distension score in the experimental group was significantly higher than that in the control group(t=5.69,P<0.01).Motilin and gastrin in the experimental group were significantly higher than those in the control group(t=5.70,P<0.01,t=20.89,P<0.01).The endothelin in the experimental group was significantly lower than that in the control group(t=8.43,P<0.01).Conclusions:Electric stimulation at bilateral Zusanli(ST36)can promote the recovery of gastrointestinal function in pregnant women after delivery,reduce the incidence of abdominal distention and abdominal pain,and the mechanism may be associated with increasing serum motilin and gastrin and reducing endothelin.