耳穴压豆联合穴位按摩治疗对胃癌术后胃肠功能恢复及脑肠肽分泌的影响

Effect of auricular acupoint pressing combined with acupoint massage in the treatment of recovery of gastrointestinal function and secretion of brain gut peptide after gastric cancer surgery

目的探讨耳穴压豆联合穴位按摩治疗对胃癌术后胃肠功能恢复及脑肠肽分泌的影响。方法选取2016年7月~2018年12月我院胃肠外科行胃癌根治术患者80例,采用抛银币法分为干预组与对照组各40例。两组予全麻下腹腔镜胃癌根治术,术后予围手术期常规干预,对照组在此基础上予穴位按摩,干预组在此基础上予耳穴压豆联合穴位按摩治疗,两组均连用5 d。观察两组患者术前2 d与术后2 d血清脑肠肽(胃动素和P物质)指标变化,并比较胃肠功能恢复指标和住院时间。结果术后2 d,两组血清胃动素和P物质指标均较术前2 d显著下降(P<0.05或P<0.01),且干预组胃动素和P物质水平下降值少于对照组(P<0.05);干预组患者术后肠蠕动恢复时间、首次排气时间、首次排便时间和住院时间较对照组更短(P<0.05)。结论耳穴压豆联合穴位按摩治疗用于胃癌术后可减少术后胃动素和P物质水平下降幅度,促进胃肠道蠕动,有利于胃肠功能恢复。

Objective To investigate the effect of auricular acupoint pressing combined with acupoint massage on the recovery of gastrointestinal function and secretion of brain gut peptide after gastric cancer surgery.Methods From July 2016 to December 2018,80 patients with radical gastrectomy in the department of gastrointestinal surgery in our hospital were selected.The method of flipping silver coins was used to divide the patients into the intervention group and control group,with 40 patients in each group.Laparoscopic radical gastrectomy was performed in both groups under general anesthesia.Perioperative routine intervention was performed after surgery.The control group was given acupoint massage on this basis.On the basis of this,the intervention group was given auricular acupoint pressing combined with acupoint massage.The treatment was given for 5 days in both groups.The changes of serum brain gut peptide(motilin and substance P)levels were observed 2 days before and 2 days after surgery in both groups,and the gastrointestinal function recovery indicators and length of stay were compared.Results At 2 days after surgery,serum motilin and substance P levels in the two groups were significantly lower than those 2 days before surgery(P<0.05 or P<0.01).The descending value of motilin and substance P in the intervention group were lower than those in the control group(P<0.05);the postoperative bowel movement recovery time,first exhaust time,first defecation time and length of stay were significantly shorter in the intervention group than in the control group(P<0.05).Conclusion Auricular acupoint pressing combined with acupoint massage for postoperative gastric cancer can reduce the decrease of postoperative motilin and substance P and promote gastrointestinal motility,which is beneficial to the recovery of gastrointestinal function.