足三里、太冲、合谷穴位针刺辅助治疗对全麻妇科腹腔镜手术后康复效果、中医证候积分和并发症的影响

Effect of Acupuncture Assisted Treatment at Zusanli,Taichong and Hegu Acupoints on Postoperative Rehabilitation,TCM Syndrome Score and Complications of Patients Undergoing Gynecological Laparoscopic Under General Anesthesia

目的探究足三里、太冲、合谷穴位针刺辅助治疗对全麻妇科腹腔镜手术后康复效果、中医证候积分和并发症的影响。方法选取2023年1月至2024年3月行全麻妇科腹腔镜手术的90例患者,采用随机数字表法分为常规组和中医组,每组45例。常规组术后给予常规处理,中医组在常规处理基础上给予足三里、太冲、合谷穴位针刺。比较2组术后胃肠功能、术后疼痛[视觉模拟评分法(VAS)评分],比较2组治疗前和治疗14 d后中医证候积分、康复状况[加速康复外科(ERAS)康复评分、首次下床时间、住院时间]、炎性因子[C反应蛋白(CRP)、降钙素、白细胞介素-8(IL-8)]水平,统计治疗期间2组并发症(恶心呕吐、感染、腹痛、腹胀、头痛)发生情况。结果中医组术后排气、术后排便、术后进食、肠鸣音恢复时间以及下床时间和住院时间均短于常规组(P<0.05)。术后6、12、24 h,中医组疼痛VAS评分均低于常规组(P<0.05)。治疗14 d,2组CRP、降钙素、IL-8水平及各中医证候积分较治疗前降低,且中医组低于常规组(P<0.05);治疗14 d,2组ERAS康复评分较治疗前升高,且中医组高于常规组(P<0.05)。中医组并发症总发生率低于常规组(P<0.05)。结论足三里、太冲、合谷穴位针刺辅助治疗可有效改善全麻妇科腹腔镜手术后患者胃肠功能,缓解术后疼痛及炎症反应,减轻临床症状,促进术后康复,减少并发症发生。

Objective To explore the effect of acupuncture assisted treatment at Zusanli,Taichong and Hegu acu-points on postoperative rehabilitation,traditional Chinese medicine(TCM)syndrome score and complications of patients un-dergoing gynecological laparoscopic surgery under general anesthesia.Methods A total of 90 patients who underwent gyneco-logical laparoscopic surgery under general anesthesia from January 2023 to March 2024 were selected and divided into conven-tional group and TCM group by random number table method,with 45 cases in each group.The conventional group was given routine treatment after operation,and the TCM group was given Zusanli,Taichong and Hegu acupoints on the basis of routine treatment.Postoperative gastrointestinal function and postoperative pain[visual analogue scale(VAS)score]were compared between the two groups.TCM syndrome scores,rehabilitation status[Enhanced Recovery after Surgery(ERAS)rehabilitation score,the time of first off-bed activity,length of hospital stay],and levels of inflammatory factors[C reactive protein(CRP),calcitonin,interleukin-8(IL-8)]were compared between the two groups before treatment and at 14 d after treat-ment.The incidence of complications(nausea,vomiting,infection,abdominal pain,abdominal distension,headache)in the two groups during treatment was analyzed.Results The time of postoperative exhaust,postoperative defecation,postoperative food intake,bowel sound recovery time,time of off-bed activity and the length of hospital stay time in TCM group were shorter than those in conventional group(P<0.05).At 6,12 and 24 h after operation,the VAS pain score in the TCM group was lower than that in the conventional group(P<0.05).At 14 d after treatment,the levels of CRP,calcitonin,IL-8 and TCM syndrome scores in the two groups were lower than before treatment,and lower in the TCM group than in the conventional group(P<0.05).At 14 d after treatment,ERAS rehabilitation score of the two groups was higher than that before treatment,which was higher in the TCM group than in the conventional group(P<0.05).The total complication rate of TCM group was lower than that of conventional group(P<0.05).Conclusion Acupuncture assisted treatment at Zusanli,Taichong and Hegu acupoints can effectively improve postoperative gastrointestinal function,relieve postoperative pain and inflammation,al-leviate clinical symptoms,promote postoperative rehabilitation and reduce complications in patients undergoing gynecological laparoscopic surgery under general anesthesia.