温针灸联合穴位按摩对腹腔镜阑尾切除术后胃肠功能的影响

Effect of Needle Warming Therapy Combined with Acupoint Massage on Gastrointestinal Function After Laparoscopic Appendectomy

目的观察温针灸联合穴位按摩对腹腔镜阑尾切除术后患者胃肠功能及血清胃泌素(GAS)、胃动素(MTL)、血管活性肠肽(VIP)和炎症指标的影响。方法回顾性分析150例行腹腔镜阑尾切除术患者的临床资料,根据术后的治疗方法分为温针灸联合穴位按摩组(50例)、针刺联合穴位按摩组(50例)和穴位按摩组(50例)。比较3组患者术后肠鸣音恢复时间、肛门排气时间、进食时间和下床活动时间以及住院时长,比较两组术前和术后第1天血清GAS、MTL、VIP、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)以及C反应蛋白(CRP)的水平。结果温针灸联合穴位按摩组术后肠鸣音恢复时间、肛门排气时间和进食时间均短于其余两组(P<0.05);针刺联合穴位按摩组术后肠鸣音恢复时间和肛门排气时间短于穴位按摩组(P<0.05)。温针灸联合穴位按摩组术后第1天血清GAS、MTL和VIP均高于其余两组(P<0.05);针刺联合穴位按摩组术后第1天血清GAS、MTL和VIP高于穴位按摩组(P<0.05);3组术后第1天血清TNF-α、IL-6和CRP水平比较,差异无统计学意义(P>0.05)。结论温针灸联合穴位按摩可促进腹腔镜阑尾切除术后患者胃肠功能的恢复,可能与促进胃肠激素分泌有关。

Objective To observe the effects of needle warming therapy combined with acupoint massage on gastrointestinal function,serum gastrin(GAS),motilin(MTL),vasoactive intestinal peptide(VIP),and inflammatory indexes in patients after laparoscopic appendectomy.Method The clinical data of 150 patients who had undergone laparoscopic appendectomy were retrospectively analyzed and divided into the combination of needle warming therapy and acupoint massage group(50 cases),the combination of acupuncture and acupoint massage group(50 cases),and the acupoint massage group(50 cases)according to the postoperative treatment.The postoperative bowel sound recovery time,anal exhaust time,time to start eating,time to get out of bed,and the length of hospitalization of the three groups were compared.The levels of serum GAS,MTL,VIP,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)before and on the first day after surgery were compared between the two groups.Result The postoperative bowel sound recovery time,anal exhaust time,and time to start eating in the combination of needle warming therapy and acupoint massage group were shorter than those in the other two groups(P<0.05).The postoperative bowel sound recovery time and anal exhaust time in the combination of acupuncture and acupoint massage group were shorter than those in the acupoint massage group(P<0.05).The serum GAS,MTL,and VIP in the combination of needle warming therapy and acupoint massage group were higher than those in the other two groups on day 1 after surgery(P<0.05).The serum GAS,MTL and VIP in the combination of acupuncture and acupoint massage group were higher than those in the acupoint massage group on day 1 after surgery(P<0.05).There were no significant differences in serum TNF-α,IL-6 and CRP levels among the three groups on day 1 after surgery(P>0.05).Conclusion Needle warming therapy combined with acupoint massage can promote the recovery of gastrointestinal function after laparoscopic appendectomy,which may be related to the promotion of gastrointestinal hormone secretion.