电针疗法在胃十二指肠溃疡穿孔治疗中的价值研究

The value of electroacupuncture in treating gastroduodenal ulcer perforation

目的研究电针疗法在胃十二指肠溃疡穿孔治疗中的价值及对血清脑肠肽(vasoactive intestinal peptide,VIP)和一氧化氮(nitric oxide,NO)水平的影响。方法本研究所选病例为2017年3月至2020年3月广州中医药大学第三附属医院收治的60例患者,按照随机对照法将患者分为观察组和对照组,每组30例。对照组患者采用腹腔镜穿孔修补术治疗,观察组患者给予腹腔镜穿孔修补术+电针疗法治疗。比较两组患者治疗疗效、肠鸣音恢复时间、胃肠减压时间和住院时间;比较治疗前后胃肠激素胃泌素(gastrin,GAS)、肾上腺髓质素(adrenal medulla,AM)、胃动素(motilin,MTL)、生长抑素(somatostatin,SS)和降钙素基因相关肽(calcitonin gene related peptide,CGRP)、VIP、NO水平变化;比较两组并发症发生情况,随访1年比较复发率。结果观察组患者总有效率为96.67%,对照组患者总有效率为76.67%,差异有统计学意义(P<0.05)。治疗后,两组胃肠激素GAS、AM、MTL水平较治疗前降低,SS、CGRP水平较治疗前升高(P<0.05);且观察组胃肠激素GAS、AM、MTL水平均低于对照组,SS、CGRP水平均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清VIP和NO水平较治疗前降低(P<0.05),且观察组血清VIP和NO水平均低于对照组(P<0.05)。观察组与对照组治疗后并发症发生率均较低,差异无统计学意义(P>0.05);观察组患者术后1年复发率比对照组低(P<0.05)。结论腹腔镜穿孔修补术基础上结合电针疗法治疗胃十二指肠溃疡穿孔临床效果显著,能有效调节患者胃肠激素、VIP和血管活性物质的分泌,患者恢复好,随访1年复发率低,值得推广应用。

Objective To evaluate the value of electroacupuncture therapy for gastroduodenal ulcer perforation and its influence on serum vasoactive intestinal peptide(VIP)and nitric oxide(NO)levels.Methods A total of 60 cases were selected from The Third Hospital of Guangzhou University of Chinese Medicine from March 2017 to March 2020.According to the randomized control method,60 patients were divided into observation group and control group,with 30 cases in each.The control group was treated with laparoscopic perforation repair.The observation group was treated with laparoscopic perforation repair and electroacupuncture.The therapeutic effect,intestinal sound recovery time,gastrointestinal decompression time and hospital stay were compared between the two groups.The gastrointestinal hormones gastrin(GAS),adrenal mMedulla(AM),motilin(MTL),somatostatin(SS),calcitonin gene-related peptide(CGRP),VIP and NO levels were compared before and after treatment.Complications were compared between the two groups,followed up for 1 year to compare the recurrence rate.Results The overall effective rate was 96.67%in observation group and 76.67%in control group and the differences were statistically significant(P<0.05);the levels of GAS,AM and MTL in gastrointestinal hormones after treatment in two groups were lower than those before treatment,and the levels of SS and CGRP in observation group were higher than those before treatment(P<0.05);after treatment,the levels of gastrointestinal hormones GAS,AM and MTL in the observation group were lower than those in control group,and the levels of SS and CGRP in observation group were higher than those in control group,and the differences were statistically significant(P<0.05);after treatment,the levels of VIP and NO in serum of two groups decreased than before(P<0.05),and the VIP and NO levels in observation group were lower than those in control group.The incidence rates of complications after treatment in observation group were lower than those in the control group,and the differences were not statistically significant(P>0.05).The recurrence rate 1 year after operation in the observation group were lower than those in the control group(P<0.05).Conclusion Laparoscopic perforation repair combined with electroacupuncture therapy may have significant clinical effect on gastroduodenal ulcer perforation,which can effectively regulate the secretion of gastrointestinal hormones,cerebroenteric peptides and vasoactive substances.Since the patients have shown good recovery and low one-year recurrence rate,the therapy is worthy of application and promotion.