耳穴压豆联合经皮穴电刺激预防乳腺癌术后恶心呕吐的效果

Effect of auricular acupoint pressing beans combined with transcutaneous acupoint electrical stimulation on preventing postoperative nausea and vomiting after radical mastectomy

目的观察耳穴压豆联合经皮穴电刺激预防乳腺癌术后恶心呕吐(PONV)的效果。方法 择期行全身麻醉下乳腺癌根治术患者120例,随机分为4组:对照组(A组)、耳穴压豆组(B组)、经皮穴电刺激(C组)、耳穴压豆联合经皮穴电刺激(D组)。检测术前、术后12 h、术后24 h血清5-羟色胺(5-HT)浓度、胃动素(MTL)含量和胃泌素(GAS)含量;评估术后30 min、6、12、24 h PONV发生率。结果 与A组比较,C、D组术后6、12、24 h PONV发生率更低(P <0.05);B、C、D组术后12 h和术后24 h血清MTL、GAS升高(P <0.05);C、D组术后12 h和24 h血清5-HT降低(P <0.05)。结论 耳穴压豆联合经皮穴电刺激能有效减轻乳腺癌患者PONV发生率,调节胃肠激素,并降低血浆5-HT水平,是一种安全有效的非药物疗法,可推广。

Objective To observe the effect of auricular acupoint pressing beans combined with transcuta⁃neous acupoint electrical stimulation(TAES)for preventing postoperative nausea and vomiting(PONV)after radi⁃cal mastectomy.Methods A total of 120 female patients undergoing radical mastectomy under general anesthesia were randomly assigned to four groups:control group(group A),auricular acupoint pressing beansauricular acu⁃point pressing beans group(group B),TAES group(group C),auricular acupoint pressing beans combined with TAES(group D).The concentration of plasma 5⁃hydroxytryptamine(5⁃HT),motilin(MTL)and gastrin(GAS)were measured by enzyme⁃linked immunosorbent assay(ELISA)before,12 hours and 24 hours after operation.The inci⁃dence of PONV 30 minutes,6 hours,12 hours,and 24 hours after operation were recorded.Results Compared with group A,the incidence of PONV 6 h,12 h and 24 h after operation significantly reduced in group C and D(P<0.05).Compared with group A,MTL and GAS were elevated in groups B,C and D at 12 h and 24 h after opera⁃tion(P<0.05)and the concentration of 5⁃HT 12 and 24 hours after operation was significantly decreased in group C and D(P<0.05).Conclusion Auricular acupoint pressing beans combined with TAES after radical mastecto⁃my could prevent PONV effectively,regulate gastrointestinal hormones,and reduce the concentration of plasma 5⁃HT without obvious side effects.It is a safe and effective non⁃pharmacological therapy that can be promoted.