Analysis of the Effect of Transcutaneous Electrical Stimulation of Acupoints Combined with Rehabilitation Training in The Treatment of Upper Limb Dysfunction After Stroke

Objective:To analyze the effect of combining transcutaneous electrical acupoint stimulation(TEAS)with rehabilitation training in patients with upper limb dysfunction after stroke(ULDAS).Methods:A total of 130 ULDAS patients who were hospitalized and rehabilitated in Wuxi Xinwu District Rehabilitation Hospital from May 2021 to May 2023 were selected and randomly divided into Group A(65 cases,rehabilitation training)and Group B(65 cases,rehabilitation training+TEAS).The effects of the two groups were compared.Results:After treatment,the upper limb functional indexes of Group B were better than those of Group A(P<0.05).The rate of muscle tone grades 0-4 in Group B was higher than those of Group A(P<0.05).Conclusion:The function of upper limbs and muscle strength of ULDAS patients improved by combining TEAS with rehabilitation training.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective:To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation.Methods:From January to September 2022,300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups,low frequency,high frequency,and alternating frequency,with 100 cases in each group.In addition to routine postpartum care and psychological counseling,the three groups received transcutaneous electrical acupoint stimulation at low-frequency(2 Hz,)high-frequency(100 Hz),and alternating frequency(2/100 Hz),respectively.The differences in initial pain,pain scores before and after treatment,satisfaction with analgesic effect,and postpartum rehabilitation effect were evaluated among the three groups of patients.Results:There was a significant correlation between maternal age and postpartum pelvic girdle pain(P<0.001),but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain(P>0.05).After 1d/2d of treatment,the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group,and the postpartum curative effect of patients in the alternating-frequency group was the best,followed by the low-frequency group,and the high-frequency group;the differences were statistically significant(P<0.001).Among the three groups,the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time;the differences were statistically significant(P<0.001).Conclusion:Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation.Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain.It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction.Therefore,its application in clinical practice is highly recommended.

Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection:A randomized controlled trial

BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

Effect of percutaneous electrical stimulation at the Baliao point on preventing postpartum urinary retention after labor analgesia

BACKGROUND Anesthetic drugs used in labor analgesia also paralyze the bladder muscle by blocking the sacral plexus,thereby affecting maternal postpartum spontaneous urination and increasing the risk of postpartum urinary retention(PUR).AIM To analyze the effect of percutaneous electrical stimulation at the Baliao point combined with biofeedback therapy for PUR prevention.METHODS We selected 182 pregnant women who received labor analgesia in obstetrics between June 2022 and December 2023.They were divided into the combined therapy group(transcutaneous electrical stimulation of the Baliao point combined with biofeedback therapy)and the control group(biofeedback therapy alone).The first spontaneous urination time,first postpartum urine volume,bladder residual urine volume,postpartum hemorrhage volume,pre-urination waiting time,PUR incidence,adverse reactions,and the intervention’s clinical efficacy were compared between the two groups.RESULTS The first spontaneous urination time after delivery was more delayed(2.92±1.04 h vs 3.61±1.13 h,P<0.001),with fewer initial postpartum urine(163.54±24.67 mL vs 143.72±23.95 mL,P<0.001),more residual bladder urine(54.81±10.78 mL vs 65.25±13.52 mL,P<0.001),more postpartum bleeding(323.15±46.95 mL vs 348.12±45.03 mL,P=0.001),and longer waiting time for urination(0.94±0.31 min vs 1.29±0.42 min,P<0.001),in the control group than in the combined therapy group.The control group also had higher PUR incidence(4.65%vs 15.85%,P=0.016).Both groups had no adverse reactions,but the clinical total efficacy rate of the intervention was significantly higher in the combined therapy group than in the control group(95.35%vs 84.15%,P=0.016).CONCLUSION Percutaneous electrical stimulation of the Baliao point combined with biofeedback can significantly promote postpartum micturition of parturients with labor analgesia,thereby effectively preventing PUR occurrence.

Effect of transcutaneous electrical acupoint stimulation combined with palonosetron on chemotherapy-induced nausea and vomiting: a single.blind,randomized, controlled trial

Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation(TEAS) on nausea and vomiting after TACE.Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active?acupuncture(n = 72) or placebo?acupuncture(n Hegu(LI4), Neiguan(P6), an= 70) groups using a covariate?adaptive randomization at a ratio of 1:1. The acupointsd Zusanli(ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory(MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant(all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active?acupuncture group than in the placebo?acupuncture group and continued to decrease over time with treat?ment(all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active?acupuncture group were slightly lower than those for the placebo?acupuncture group, but the differences were not statistically significant(all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event(P > 0.05).Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.

Evaluation of the Efficacy of Transcutaneous Electrical Acupoint Stimulation during the Treatment of Painless Colonoscopy

Objective:To investigate the clinical efficacy of transcutaneous electrical acupoint stimulation combined with propofol infusion during the treatment of patients under colonoscopy.Methods:A total of 90 patients received painless colonoscopy were randomly divided into three groups:transcutaneous electrical acupoint stimulation combined with propofol group(group T),sufentanil combined with propofol group(group S)and propofol group(group P),with 30 cases in each group.The patients in group T were anesthetized with propofol after transcutaneous electrical acupoint stimulation of 30min at Hegu(LI4),Neiguan(PC6),Zusanli(ST36),Shangjuxu(ST37)and Sanyinjiao(SP6)on both sides,and the electrical stimulation lasted until the end of the operation.Group S and group P were pasted electrode slices at the same acupoint with group T,but no electrical stimulation was given.The other treatments were the same as those in group T.Group S was given sufentanil 0.1ug/kg at the beginning of anesthesia.The levels of blood pressure(MAP),heart rate(HR)and pulse oxygen saturation(SpO2)were continuously monitored at time points of entering operating room(T0),disappearance of eyelash reflex(T1),during operation(through the liver region T2)and immediately after operation(T3),and the total dosage of propofol,awakening time and incidence of adverse reactions in each group were recorded.Results:Compared with group P,the blood pressure and heart rate of the patients at T1 and T2 in group T were more stable(P<0.05),the awakening time after operation was significantly shorter(P<0.05),and the dosage of propofol was significantly lower than that in group P(P<0.05).The incidence of bradycardia,hypotension and respiratory depression decreased significantly(P<0.05).Compared with group S,the postoperative awakening time of group T was significantly shorter(P<0.05),and there was no significant difference in other indexes.Conclusion:Transcutaneous electrical acupoint stimulation is effective during the treatment of analgesia under colonoscopy.It can reduce the dosage of anesthetics,reduce the incidence of postoperative adverse reactions and shorten the awakening time of patients.

Transcutaneous acupoint electrical stimulation(TAES)for pre-operative anxiety:a prospective observational pilot investigation

Objective:Transcutaneous acupoint electrical stimulation(TAES)treatment is effective for post-operative anxiety.The investigation was designed to study the feasibility and effectiveness of TAES treatment for pre-operative anxiety.Methods:62 volunteered surgical patients were included in the pilot investigation.They all received TAES treatment for 30 minutes in the evening of the day before operation.Hegu(LI4)and Neiguan(PC6)of both sides were selected as the treatment acupoints.The anxiety degrees were measured by State-Trait Anxiety Inventory.Heart rate and blood pressure were also recorded.Results:After TAES,pre-operative anxiety measured by State-Trait Anxiety Inventory dropped by almost 12%,and both heart rate and systolic blood pressure decreased significantly.Conclusion:The pilot investigation of TAES for pre-operative anxiety can successfully test the feasibility of outcome measurements and provide necessary data for calculating the sample size of a subsequent randomized controlled trial.

基于光学相干断层扫描血管成像术探讨Eye-TEAS防治儿童近视疗效及作用机制

目的:基于光学相干断层扫描血管成像术(OCTA)探讨眼周经皮穴位电刺激仪(Eye-TEAS)防治儿童近视的疗效和机制。方法:纳入60名近视儿童,记录黄斑中心凹下脉络膜厚度(SFCT)等眼部各参数水平,并对各参数进行相关性分析;采用Eye-TEAS对受试者进行3个月的干预治疗,每天30 min,每周使用不低于5次。检测Eye-TEAS干预前、干预1次后、干预1个月后、干预3个月后受试者等效屈光度(SER)、眼轴长度(AL)、SFCT及黄斑区3 mm×3 mm面积内的脉络膜中大血管密度(CVD)、脉络膜毛细血管密度(CCVD)的变化情况。结果:58名近视儿童完成了干预及随访,在基线数据观察中,SER与SFCT、CCVD均呈显著正相关(P<0.01),AL与SER、SFCT、CVD、CCVD呈显著负相关(P<0.05或P<0.01)。相较于干预前,干预第1次后、1个月后、3个月后SER、AL均未发生显著变化(P>0.05)。干预第1次后SFCT与基线水平比较,差异无统计学意义(P>0.05)。干预1个月、3个月后SFCT与基线水平比较,差异均有统计学意义(P<0.05),其中干预1个月后SER变化和SFCT变化呈显著正相关(P<0.05)。在干预第1次、干预1个月后CVD较基线水平增加(P<0.05),但干预3个月后CVD与基线水平比较,差异无统计学意义(P>0.05)。相较于基线数据,干预1个月后和干预3个月后CCVD均显著升高(P<0.01)。结论:近视儿童SFCT、眼底微循环情况与AL、SER具有高度相关性;Eye-TEAS干预后SFCT显著增厚,CVD、CCVD也显著增加,这可能与Eye-TEAS通过影响脉络膜血流的变化减缓近视的进展有关。

Transcutaneous electrical acupoint stimulation benefits postoperative pain relief of oocyte retrieval:A randomized controlled trial

Background Transvaginal oocyte retrieval is frequently followed by adverse events related to anesthesia and the procedure.Some research showed that transcutaneous electrical acupoint stimulation(TEAS)can relieve intraoperative pain and postoperative nausea.Objective This study examined whether TEAS can alleviate pain and relieve adverse symptoms after oocyte retrieval.Design,setting,participants and interventions Altogether 128 patients were randomly divided into the TEAS group and the mock TEAS group.The two groups received a 30-minute-long TEAS or mock TEAS treatment that began 30 min after oocyte retrieval.Main outcome measures The primary outcome was the visual analog scale(VAS)pain score.Secondary outcomes were pressure pain threshold,McGill score,pain rating index(PRI),present pain intensity(PPI),VAS stress score,VAS anxiety score,and postoperative adverse symptoms.Results The baseline characteristics of the two groups were comparable(P>0.05).The VAS pain scores of the TEAS group were lower than those of the mock TEAS group at 60 and 90 min after oocyte retrieval(P<0.05).The McGill score,PRI and PPI in the TEAS group were significantly lower than those in the control group at 60 min after oocyte retrieval(P<0.05).However,the two groups had equivalent beneficial effects regarding the negative emotions,such as nervousness and anxiety(P>0.05).The TEAS group was superior to the mock TEAS group for relieving postoperative adverse symptoms(P<0.05).Conclusion TEAS treatment can relieve postoperative pain and postoperative adverse symptoms for patients undergoing oocyte retrieval.

TEAS联合核心训练干预产后腹直肌分离及腰背痛的可行性

目的观察TEAS联合核心训练干预产后腹直肌分离与腰背痛的的可行性。方法选择2020年1月—2022年12月浙江中医药大学附属湖州中医院90例产后腰痛患者作为研究对象,对腹直肌分离程度与腰背疼痛评分进行Pearson相关性分析。将90例产后腰痛患者随机分成三组,分别为对照组、治疗1组、治疗2组,每组30例。对照组采用常规的产后自然恢复法;治疗1组在对照组的基础上加予核心训练,1次/d,5次/周,4周为1个疗程,连续1个疗程;治疗2组在治疗1组的基础上采用TEAS疗法,1次/d,5次/周,4周为1个疗程,连续1个疗程。治疗前及1个疗程结束后,评估腹直肌分离程度(IRD)、腰背疼痛症状(SF-MPQ)、身体质量指数(BMI),并观察治疗前后这些指标的变化。结果治疗结束后,各组IRD、SF-MPQ评分及BMI较治疗前明显下降,下降幅度以治疗2组最为明显,差异有统计学意义(P<0.05)。IRD与SF-MPQ评分之间呈正相关(r=0.320,P<0.05)。结论腹直肌分离与腰背痛具有相关性,TEAS联合核心训练干预可有效缩小产后腹直肌分离程度,减轻腰背疼痛,降低身体质量指数,该疗法具有临床可行性。

TEAS在肝脏缺血/再灌注过程中对肝功能及肝细胞形态学变化的影响

目的:探讨经皮穴位电刺激(TEAS)在肝脏缺血/再灌注(I/R)过程中对肝功能生化指标、肝细胞形态学的影响。方法:将12只雄性SD大鼠随机分为对照组、模型组、模型+假TEAS组、模型+TEAS组,每组3只。对照组仅行开腹不使用血管夹闭处理,模型组建立非致死性肝脏节段(70%)I/R模型,模型+假TEAS组使用安慰贴片取穴向外旁开5 mm,不实施任何电流刺激,模型+TEAS组以TEAS干预,实验过程中TEAS介入共3次。采用全自动生化分析仪及免疫组化技术测定各组大鼠血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、肝组织乙酰转移酶(CAT)和谷胱甘肽(GSH)等肝功能指标的变化,并对肝组织行苏木精-伊红(HE)染色,观察各组切片炎症细胞浸润情况。结果:模型组、模型+假TEAS组、模型+TEAS组大鼠的ALT、AST含量均高于对照组,差异具有统计学意义(P<0.05);与模型组相比,模型+TEAS组大鼠的ALT、AST含量均明显降低,差异具有统计学意义(P<0.05)。模型组、模型+假TEAS组、模型+TEAS组大鼠的GSH、CAT含量均低于对照组,差异具有统计学意义(P<0.05);与模型组相比,模型+TEAS组大鼠的GSH、CAT含量均有不同程度的增高,但是各组间比较,差异无统计学意义(P>0.05)。HE染色显示模型+TEAS组的炎症细胞浸润情况明显好于模型组。结论:TEAS在肝脏I/R过程中能有效改善肝功能损伤情况,并能有效改善在肝脏I/R后肝细胞的形态学变化,起到肝保护作用。

Transcutaneous Electrical Acupoint Stimulation Combined with Warm Acupuncture for Breast Cancer Related Upper Limb Lymphedema:A Retrospective Cohort Study

Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema(BCRL).Methods This was a retrospective cohort study using a paired control design.Fifty-two BCRL patients were assigned to the control group(27 cases)and the treatment group(25 cases).The patients in the control group were treated with lymphedema comprehensive detumescence treatment(CDT)for 4 weeks,including systematic therapy composed of manual lymphatic drainage,compression bandage,skincare,and functional exercise.The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods.Each treatment lasted for 30 min and was applied twice a week for 4 weeks.The arm circumference(AC)of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment.The clinical efficacy was evaluated according to the degree of edema before and after treatment.All adverse events during treatment were recorded.Results The patients’AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment.Compared with the control group,AC of the wrist joint transverse stria,the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced(P<0.05).The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant(P<0.01).The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment,and was significantly lower compared with the control group after treatment(P<0.01).The total effective rate was 72%in the treatment group,significantly higher than that in the control group(55.56%,P<0.05).No serious adverse events occured in either group.Conclusions TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL.The effect is better than that of CDT therapy alone.

不同穴位配伍TEAS联合全麻对腹腔镜胆囊切除术患者术后不良反应的影响

目的探讨不同穴位配伍经皮穴位电刺激(TEAS)联合全麻对腹腔镜胆囊切除术(LC)患者术后胃肠功能及恶心呕吐的影响。方法将LC患者120例,将其按随机数字表法分为A组、B组、C组,各40例。A组采用常规全麻,B组采用常规全麻联合TEAS(内关、合谷),C组采用常规全麻联合TEAS(内关、合谷、足三里)。比较3组患者术中丙泊酚与瑞芬太尼用量、气管拔管时间、术后补救镇痛、胃肠激素水平及术后恶心呕吐分级情况。结果术后2、12、24 h,B组、C组疼痛视觉模拟(VAS)评分明显低于A组(P<0.05),且B组、C组间比较差异无统计学意义(P>0.05);治疗后,B组、C组丙泊酚、瑞芬太尼用量、气管拔管时间及术后补救镇痛率明显低于A组(P<0.05),且B组、C组间比较差异无统计学意义(P>0.05);术后12 h,各组胃动素、胃泌素水平较术前明显降低(P<0.05),且B组、C组明显高于A组(P<0.05),C组明显高于B组(P<0.05);术后24 h,C组恶心呕吐分级情况明显优于A、B组(P<0.05),A组、B组比较差异无统计学意义(P>0.05)。结论TEAS可减少LC患者术中阿片类药物使用量,减轻患者术后疼痛;且内关、合谷、足三里穴配伍TEAS有助于改善LC患者胃肠功能及恶心呕吐情况。

经皮穴位电刺激(TEAS)特定穴联合补肾益智活血汤对急性脑损伤患者认知功能、血清神经损伤标志物的影响

【目的】分析经皮穴位电刺激(TEAS)特定穴联合补肾益智活血汤对急性脑损伤患者认知功能、血清神经损伤标志物的影响。【方法】通过便利抽样法,回顾性收集100例急性脑损伤患者,根据治疗方法的不同分为观察组和对照组,每组各50例。对照组给予常规西医治疗,观察组在对照组的基础上给予TEAS特定穴联合补肾益智活血汤治疗,疗程为3周。观察2组患者治疗前和治疗1周、2周、3周后格拉斯哥昏迷指数(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分、血清神经损伤标志物水平及颅内动脉血流速度的变化情况,比较2组患者的临床疗效、脑血管痉挛(CVS)和不良反应发生率。【结果】(1)治疗3周后,观察组的总有效率为96.00%(48/50),对照组为76.00%(38/50),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)观察组治疗1周、2周、3周后和对照组治疗2周、3周后的GCS评分、MoCA评分均较治疗前升高(P<0.05),NIHSS评分均较治疗前降低(P<0.05),且观察组在治疗1周、2周、3周后对GCS评分、MoCA评分的升高幅度及对NIHSS评分的降低幅度均明显优于对照组(P<0.05或P<0.01)。(3)观察组治疗1周、2周、3周后和对照组治疗2周、3周后的血清神经元特异性烯醇化酶(NSE)、神经肽Y(NPY)水平均较治疗前降低(P<0.05),且观察组在治疗1周、2周、3周后对血清NSE、NPY水平的降低幅度均明显优于对照组(P<0.05或P<0.01)。(4)观察组治疗1周、2周、3周后和对照组治疗2周、3周后的椎动脉(VA)、基底动脉(BA)、大脑中动脉(MCV)血流速度均较治疗前升高(P<0.05),且观察组在治疗1周、2周、3周后对VA、BA、MCV血流速度的升高幅度均明显优于对照组(P<0.05或P<0.01)。(5)观察组的CVS发生率为2.00%(1/50),明显低于对照组的16.00%(8/50),差异有统计学意义(P<0.05)。(6)观察组的不良反应发生率为4.00%(2/50),对照组为8.00%(4/50),组间比较,差异无统计学意义(P>0.05)。【结论】TEAS特定穴联合补肾益智活血汤可有效改善急性脑损伤患者神经功能和认知功能,减轻脑损伤与昏迷程度,降低CVS发生率,且联合治疗并未增加不良反应,具有一定的安全性。

经皮穴位电刺激联合中医情志干预对腹腔镜直肠癌根治术患者免疫功能和心理应激的影响

【目的】评价经皮穴位电刺激(TEAS)联合中医情志干预对腹腔镜直肠癌根治术患者免疫功能和心理应激的影响。【方法】将100例住院拟行腹腔镜直肠癌根治术治疗的患者随机分为A、B、C、D 4组,每组各25例。A组给予麻醉前TEAS 30 min,B组给予持续TEAS至手术结束,C组给予麻醉前TEAS 30 min+中医情志干预,D组给予持续TEAS至手术结束+中医情志干预,其中,TEAS取穴足三里(双侧)、三阴交(双侧)、百会、内关(双侧)。观察各组围术期指标以及术前与术后3 d免疫功能指标、Th1/Th2细胞分子机制、心理应激反应指标的变化情况,并比较各组的不良反应发生情况。【结果】(1)围术期指标方面,4组患者的手术时间、出血量、输液量比较,差异均无统计学意义(P>0.05);D组的舒芬太尼用量、瑞芬太尼用量、术后苏醒时间、术后24 h痛觉模拟量表(VAS)评分均低于A组、B组、C组(P<0.05),而B组、C组的上述指标均低于A组(P<0.05)。(2)免疫功能指标方面,D组术后3 d的T淋巴细胞亚群CD3+、CD4+及自然杀伤(NK)细胞水平均高于A组、B组、C组(P<0.05),而B组、C组的上述指标均高于A组(P<0.05)。(3)Th1/Th2细胞分子机制方面,D组术后3 d的血清白细胞介素2(IL-2)、γ干扰素(IFN-γ)水平均高于A组、B组、C组(P<0.05),血清白细胞介素10(IL-10)水平均低于A组、B组、C组(P<0.05),而B组、C组的血清IL-2、IFN-γ水平均高于A组(P<0.05),血清IL-10水平均低于A组(P<0.05)。(4)心理应激反应指标方面,D组术后3 d的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均低于A组、B组、C组(P<0.05),而B组、C组的上述评分均低于A组(P<0.05)。(5)不良反应方面,A组出现1例恶心呕吐,B组出现2例恶心呕吐、1例头晕,C组无不良反应,D组出现1例恶心呕吐,不良反应发生率分别为4.0%(1/25)、12.0%(3/25)、0.0%(0/25)、4.0%(1/25),组间比较,差异无统计学意义(χ2=0.400,P=0.527)。【结论】针对腹腔镜直肠癌根治术患者,TEAS联合中医情志干预可有效调节患者围术期免疫功能,减轻应激反应,缓解患者紧张焦虑状态,同时可产生一定的镇痛作用,减少阿片类药物用量,提高患者围术期舒适度及手术耐受水平。

厚朴排气合剂联合经皮穴位电刺激对产后抑郁合并胃肠功能障碍患者胃肠功能及抑郁情绪的影响

目的:探讨厚朴排气合剂联合经皮穴位电刺激对产后抑郁合并胃肠功能障碍的临床效果。方法:将120例产后抑郁合并胃肠功能障碍患者随机分为观察组(n=60)和对照组(n=60)。对照组给予经皮穴位电刺激治疗,观察组给予厚朴排气合剂联合经皮穴位电刺激治疗,疗程均为7 d。比较两组患者胃肠功能恢复情况、胃肠道障碍症状评分、胃泌素(GAS)、胃动素(MTI)、腹胀发生率、腹胀程度、汉密尔顿抑郁量表评分以及不良反应发生情况。结果:与对照组相比,观察组患者的肠鸣音恢复、首次肛门排气、首次排便、总住院时间明显更短(P<0.05)。治疗后,两组患者胃肠道障碍症状评分均明显下降,观察组低于对照组(P<0.05)。治疗后,两组患者GAS、MTI水平和治疗前相比均明显升高,且观察组高于对照组(P<0.05)。治疗后,观察组患者腹胀发生率为11.7%,低于对照组的30.0%(P<0.05)。治疗后,观察组患者腹胀程度明显低于对照组(P<0.05)。治疗后,两组患者抑郁状态评分均明显下降,观察组低于对照组(P<0.05)。两组不良反应发生率(6.7%与5.0%)比较差异无统计学意义(P>0.05)。结论:厚朴排气合剂联合经皮穴位电刺激可有效促进产后抑郁合并胃肠功能障碍患者胃肠功能恢复,缓解腹胀和抑郁情绪,而且不会明显增加不良反应发生率。

经皮穴位电刺激对老年肝癌患者术后早期认知功能障碍及血清相关炎症因子的影响

目的 探讨经皮穴位电刺激(TEAS)对老年肝癌患者术后早期认知功能障碍(POCD)及血清相关炎症因子的影响。方法 选取本院收治的行手术治疗的100例肝癌患者,使用随机数字表法分为两组(各50例),TEAS组从麻醉前开始至术毕始终给予TEAS,对照组不进行电流刺激。记录围术期指标、术后疼痛程度、POCD发生情况,并比较两组手术前后的血清S-100β蛋白(S-100β)、神经元特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平变化。结果 两组的围术期指标及术后24 h VAS评分接近(P>0.05)。与对照组相比,TEAS组的丙泊酚用量、瑞芬太尼用量均明显更少(P<0.05)。与术前1 d相比,两组术后1、3、7 d MMSE评分更低,且组间对比显示TEAS组的MMSE评分更高(P<0.05)。TEAS组的POCD总发生率(24.00%)明显比对照组(68.00%)更低(P<0.05)。与术前1 d相比,两组患者术后1 d的血清S-100β、NSE、IL-6及TNF-α水平均显著升高(P<0.05),且TEAS组术后1 d的血清S-100β、NSE、IL-6及TNF-α水平较对照组更低。TEAS组术后的不良反应总发生率显著低于对照组(P<0.05)。结论 在老年肝癌患者术中行TEAS治疗可发挥镇痛作用,同时还能降低炎症因子水平,减轻脑损伤,降低POCD的发生风险,有利于患者的术后康复。

经皮穴位电刺激联合低浓度布比卡因腰麻对混合痔患者术后尿潴留的影响

目的:探讨经皮穴位电刺激(TEAS)联合低浓度布比卡因腰麻对混合痔患者术后尿潴留(POUR)的影响。方法:选取60例混合痔手术患者为研究对象,根据麻醉中是否给予电刺激分为电刺激组和对照组,每组各30例。两组患者均实施低浓度布比卡因蛛网膜下腔阻滞麻醉,同时电刺激组予以TEAS,持续至术毕;对照组不予以电刺激。比较两组患者术后首次排尿等待时间、术后首次排尿量、POUR及导尿发生情况。结果:电刺激组首次排尿等待时间短于对照组(P<0.05);首次排尿量多于对照组[(253.87±19.55)mL vs.(168.79±20.14)mL,P<0.05];POUR发生率、导尿发生率低于对照组[6.67%vs.30.00%,6.67%vs.33.33%,P<0.05]。结论:TEAS联合低浓度布比卡因腰麻有助于降低混合痔术后POUR发生率,值得临床推广。

经皮穴位电刺激预防老年患者术后谵妄的Meta分析

目的:采用Meta分析评价经皮穴位电刺激(TEAS)在预防老年患者术后谵妄(POD)中的效果。方法:系统检索Pubmed、Cochrane Library、Web of Science、Embase、中国知网、万方和维普等数据库,收集建库至2023年8月30日关于TEAS治疗老年手术患者的随机对照试验(RCTs),采用RevMan 5.3软件进行Meta分析。结果:本研究共纳入22篇文献,共2645例研究对象。Meta分析结果显示,TEAS能降低老年患者术后POD的发生率(RR=0.46,95%CI:0.38,0.56),接受骨科手术(RR=0.50,95%CI:0.40,0.63)、腹部手术(RR=0.41,95%CI:0.25,0.65)及肿瘤手术(RR=0.33,95%CI:0.19,0.57)的老年患者术后POD的发生率均显著下降(均P<0.001);TEAS术中全程(RR=0.39,95%CI:0.29,0.53)或延续到术后(RR=0.52,95%CI:0.36,0.75)可明显降低老年患者术后POD发生率。结论:TEAS可有效降低行骨科、腹部及肿瘤等手术的老年患者术后POD的发生,TEAS术中全程使用或延续到术后均能有效抑制老年患者术后POD的发生,值得临床推广应用。

经皮穴位电刺激术联合君子消痞汤改善糖尿病胃轻瘫的作用及机制研究

目的观察经皮穴位电刺激术(TEAS)联合君子消痞汤治疗糖尿病胃轻瘫(DGP)的疗效,探讨其作用机制。方法64例确诊的DGP患者为研究对象,采用临床试验中央随机系统将其随机分为A组、B组、C组、D组,每组16例。A组:TEAS治疗4周后,洗脱2周,常规治疗4周;B组:君子消痞汤治疗4周后,洗脱2周,常规治疗4周;C组:TEAS+君子消痞汤治疗4周后,洗脱2周,常规治疗4周;D组:常规治疗4周后,洗脱2周,TEAS+君子消痞汤治疗4周。比较四组患者治疗前后生活质量[健康调查简表(SF-36)中的躯体性功能(PF)、角色受限(RE)、社会功能(SF)、心理健康情况(MH)、角色生理情况(RP)、活力/精力(V)、身体疼痛(BP)、综合健康情况(GH)]、胃排空功能[胃半排空时间(T_(1/2))及120 min胃内食物残留率]、疗效,分析四组患者安全性。结果四组患者治疗后PF、MH、V、BP及GH评分均较治疗前明显升高,差异有统计学意义(P<0.05);四组患者治疗后RE、SF、RP评分与治疗前比较差异无统计学意义(P>0.05)。与A组、B组治疗后相比,C组、D组患者治疗后PF、MH、V、BP及GH评分更高,差异有统计学意义(P<0.05)。四组患者治疗后T_(1/2)、120 min胃内食物残留率均较治疗前显著下降,差异有统计学意义(P<0.05)。与A组、B组患者治疗后相比,C组、D组患者治疗后T_(1/2)更短,120 min胃内食物残留率更低,差异有统计学意义(P<0.05)。四组患者总有效率分别为56.25%、62.50%、93.75%和93.75%。与A组、B组相比,C、D组治疗总有效率明显较高,差异有统计学意义(P<0.05);A组与B组、C组与D组患者总有效率相比,差异无统计学意义(P>0.05)。四组患者均能坚持治疗至疗程结束,均未见明显不良反应。各组在临床观察中,治疗前后血尿常规、大便常规、肝肾功能、血生化及心电图等各项检查指标均无明显改变。结论采用TEAS联合君子消痞汤治疗DGP可显著提高其生活质量,改善胃排空功能,提高疗效,效果优于单独应用TEAS或君子消痞汤。