经皮穴位电刺激对胃癌术后疼痛及胃肠蠕动功能的影响

Effect of Percutaneous Point Electrical Stimulation on Pain and Gastrointestinal Peristalsis Function in Patients After Surgery for Gastric Cancer

目的:观察经皮穴位电刺激对胃癌术后患者疼痛及胃肠蠕动功能的影响。方法:采用随机数字表法将80例胃癌术后患者分为对照组和试验组各40例。试验组给予围术期常规治疗及经皮穴位电刺激,对照组给予围术期常规治疗及同试验组的经皮穴位刺激操作,但不开启电源。比较2组术后恢复正常时间,以及治疗前后疼痛数字评分法(NRS)评分、胃肠蠕动功能指标[血清胃泌素(GAS)、胃动素(MOT)、生长抑素(SS)、P物质(SP)、神经降压素(NT)、胆囊收缩素(CCK)、血管活性肠肽(VIP)]水平、T淋巴细胞亚群[血浆CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)]水平、胆囊容积、胆囊排空率及腹腔压力。结果:治疗后,试验组肠鸣音恢复正常、肛门排气、排便时间及住院时间均短于对照组(P<0.05)。治疗后,2组NRS评分及血清VIP、SS、NT水平均较治疗前降低(P<0.05),血清MOT、GAS、CCK、SP水平均较治疗前升高(P<0.05);且试验组NRS评分及血清VIP、SS、NT水平低于对照组,血清MOT、GAS、CCK水平高于对照组(P<0.05),2组SP水平差异无统计学意义(P>0.05)。治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高(P<0.05),CD8^(+)水平均较治疗前降低(P<0.05);且试验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05),CD8^(+)水平低于对照组(P<0.05)。结论:胃癌术后经皮穴位电刺激后能够有效减轻患者疼痛程度,提高其免疫功能及胃肠蠕动功能,加速病情康复。

Objective:To observe the changes of pain and gastrointestinal peristalsis function in patients after surgery for gastric cancer before and after percutaneous point electrical stimulation.Methods:A total of 80 patients after surgery for gastric cancer were divided into the control group and the trial group by random number table method,with 40 cases in each group.The trial group was given perioperative conventional treatment and percutaneous point electrical stimulation,and the control group was given perioperative conventional treatment and percutaneous point stimulation,but the power was not turned on.The postoperative recovery time,pain by Numerical Rating Scale(NRS),gastrointestinal peristalsis function indexes,including serum gastrin(GAS),motilin(MOT),somatostatin(SS),Substance P(SP),neurotensin(NT),cholecystokinin(CCK)and vasoactive intestinal peptide(VIP),T lymphocyte subsets,including plasma CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),gallbladder volume,gallbladder empty rate,and abdominal pressure were compared before and after surgery in the two groups.Results:The time of bowel sounds back to normal,anal farting time,defecation time and hospitalization time in the trial group were shorter than those in the control group(P<0.05).After surgery,the NRS scores and the levels of serum VIP,SS and NT in the two groups were decreased when compared with those before surgery(P<0.05),and the levels of serum MOT,GAS,SP and CCK were increased when compared with those before surgery(P<0.05);the NRS score and the levels of serum VIP,SS and NT in the trial group were lower than those in the control group,and the levels of serum MOT,GAS and CCK in the trial groups were higher than those in the control group(P<0.05),and there was no significant difference in SP levels between two groups(P>0.05).After surgery,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were increased when compared with those before surgery(P<0.05),and the levels of CD8^(+)were decreased when compared with those before surgery(P<0.05);the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the trial group were higher than those in the control group(P<0.05),and the CD8^(+)level was lower than that in the control group(P<0.05).Conclusion:Percutaneous point electrical stimulation can effectively reduce pain,improve immune function,gastrointestinal peristalsis function,and promote postoperative recovery in patients after surgery for gastric cancer.