穴位注射联合贴敷治疗腹腔镜术后胃肠功能紊乱的疗效观察及对胃肠黏膜损伤的影响OACSTPCD
Observations on the efficacy of acupuncture point injection plus application for post-laparoscopic surgery gastrointestinal dysfunction and its effect on gastrointestinal mucosal injury
目的 观察穴位注射足三里穴联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱的临床疗效及对患者胃肠黏膜损伤修复作用和创伤应激、胃泌素调节及血清生长素释放肽(Ghrelin)和胃动素(motilin,MTL)的影响.方法 将 128 例腹腔镜术后胃肠功能紊乱患者按随机数字表法分为联合组和西医组,每组 64 例.西医组予西医常规治疗,联合组在西医常规治疗基础上予穴位注射足三里穴联合腹部穴位贴敷治疗.比较两组肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间和临床疗效,观察两组治疗前后中医证候积分、血清MTL、Ghrelin、胃泌素(gastrin,GAS)、二胺氧化酶(diamine oxidase,DAO)、D-乳酸(D-lactic acid,D-LA)、瓜氨酸、胃蛋白酶原Ⅱ、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、醛固酮和皮质醇水平的变化.结果 联合组总有效率为96.9%,高于西医组的84.4%(P＜0.05).联合组治疗后肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间均较西医组短(P＜0.05);联合组治疗后中医证候积分中疲乏无力、食欲不振、脘腹痞满、食物后痞满加重、大便溏稀和恶心呕吐的评分较西医组降低(P＜0.05);联合组治疗后血清 TNF-α、醛固酮、皮质醇、DAO、胃蛋白酶原Ⅱ和D-LA水平低于西医组(P＜0.05);联合组治疗后血清MTL、Ghrelin、GAS和瓜氨酸水平高于西医组(P＜0.05).结论 在西医常规治疗基础上,穴位注射足三里穴联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱可减少患者创伤应激反应,改善胃动力,促进胃肠黏膜损伤修复,缓解患者临床症状,提高临床疗效.
Objective To observe the clinical efficacy of point injection at Zusanli(ST36)plus abdominal acupoint application for post-laparoscopic surgery gastrointestinal dysfunction and its effect on gastrointestinal mucosal injury repair,raumatic stress,gastrin regulation,and serum ghrelin and motilin(MTL)in the patients.Method One hundred and twenty-eight patients with post-laparoscopic surgery gastrointestinal dysfunction were allocated,using a random number table,to a combination group and a Western medicine group,with 64 cases in each group.The Western medicine group received conventional Western medicine treatment and the combination group received point injection at Zusanli plus abdominal acupoint application in addition.Time to recovery of bowel sounds,time to first eating,time to anal flatus,time to defecation and the clinical efficacy were compared between the two groups.The TCM syndrome score was recorded and serum MTL,ghrelin,gastrin(GAS),diamine oxidase(DAO),D-lactic acid(D-LA),citrulline,pepsinogen Ⅱ,tumor necrosis factor-α(TNF-α),aldosterone and cortisol levels were measured in the two groups before and after treatment.Result The total efficacy rate was 96.9%in the combination group,which was higher than 84.4%in the Western medicine group(P＜0.05).After treatment,time to recovery of bowel sounds,time to first eating,time to anal flatus and time to defecation were shorter in the combination group than those in the Western medicine group(P＜0.05).After treatment,lassitude,anorexia,epigastric fullness,the fullness aggravated after eating,thin stool,and nausea and vomiting subscores in the TCM syndrome were lower in the combination group than those in the Western medicine group(P＜0.05).After treatment,serum TNF-α,aldosterone,cortisol,DAO,pepsinogenⅡ and D-LA levels were lower in the combination group than those in the Western medicine group(P＜0.05).After treatment,serum MTL,ghrelin,GAS and citrulline levels were higher in the combination group than those in the Western medicine group(P＜0.05).Conclusion On the basis of conventional Western medicine treatment,point injection at Zusanli plus abdominal acupoint application can reduce traumatic stress reactions,improve gastric motility,promote gastrointestinal mucosal injury repair,relieve the clinical symptoms in the patients and ameliorate the clinical efficacy in treating post-laparoscopic surgery gastrointestinal dysfunction.
王华;唐焕峰;袁大为;苏汝学;刘井瑞;吕炳涛
秦皇岛市中医医院,秦皇岛 066003
中医学
水针穴位贴敷法穴,足三里穴位,胸腹部术后胃肠功能紊乱胃黏膜胃动力
Hydro-acupunctureAcupoint sticking therapyPoint,Zusanli(ST36)Points,Chest and abdomenPostoperativeGastrointestinal dysfunctionGastric mucosaGastric motility
《上海针灸杂志》 2024 (006)
604-609 / 6
河北省科学技术研究与发展计划(202101A071)
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