摘要
目的评估经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)是否通过抑制炎性反应而缓解老年患者接受肺癌根治术后疲劳综合征(postoperative fatigue syndrome,POFS)。方法选取2018年1月至2020年1月于本院接受诊断并确诊为肺癌的老年患者,年龄范围为65~79岁,最终纳入择期行外科手术治疗患者80例,术式为肺癌根治术。最终被纳入的患者按照电脑随机数字表法分为TEAS组和对照组,各40例。TEAS组男24例,女16例,年龄(67.6±7.6)岁;对照组男26例,女14例,年龄(67.0±7.2)岁。TEAS组于麻醉前10 min经皮电刺激内关穴(PC6)及合谷穴(L14)直至术毕;对照组于相同穴位上贴电极片,不行电刺激。分别于术前1 d(T_(1))、术毕时(T_(2))、术后3 h(T_(3))、术后1 d(T_(4))及术后2 d(T_(5))时采集患者血液样本,血清中的肿瘤坏死因子-α(tumor necrosis factor,TNF-α)及白介素-1β(interleukin-1β,IL-1β)浓度由酶联免疫吸附法(ELISA)测定。患者POFS程度通过视觉模拟疲劳评分(Visual Analogue Fatigue Score,VAFS)评判;统计分析两组患者临床预后的主要指标。结果T_(2~5)时,两组肺癌患者血清TNF-α、IL-1β浓度均较T_(1)时明显增高,差异均有统计学意义(均P<0.05);T_(2~5)时,TEAS组血清中TNF-α浓度分别为(24.8±2.3)ng/L、(31.6±3.4)ng/L、(28.6±3.1)ng/L、(26.5±2.1)ng/L,均低于对照组(27.7±3.4)ng/L、(38.4±3.7)ng/L、(33.7±2.9)ng/L、(30.3±2.8)ng/L,IL-1β浓度分别为(4.5±2.4)pg/ml、(9.3±2.1)pg/ml、(7.6±2.3)pg/ml、(5.7±1.4)pg/ml,均低于对照组(6.9±2.3)pg/ml、(11.5±2.4)pg/ml、(9.8±2.9)pg/ml、(7.9±1.7)pg/ml,差异均有统计学意义(均P<0.05)。与T_(1)时比较,T_(4~5)时两组肺癌患者VAFS均明显增高,差异均有统计学意义(均P<0.05);T_(4~5)时,TEAS组VAFS分别为(51.9±11.4)分、(40.2±8.1)分,均低于对照组(62.3±13.2)分、(53.8±9.2)分,差异均有统计学意义(均P<0.05)。TEAS组患者术后肺部并发症发生率、麻醉后恢复室(PACU)�
Objective To assess whether transcutaneous electrical acupoint stimulation(TEAS)can alleviate postoperative fatigue syndrome(POFS)in elderly patients undergoing radical resection of lung cancer by inhibiting inflammatory response.Methods Elderly patients aged 65-79 diagnosed as lung cancer were selected from our hospital from January 2018 to January 2020.A total of 80 patients undergoing radical resection of lung cancer were enrolled for the trial.According to the computerized random number table method,the patients included were divided into a TEAS group(n=40)and a control group(n=40).There were 24 males and 16 females in the TEAS group,with the age of(67.6±7.6)years old;there were 26 males and 14 females in the control group,with the age of(67.0±7.2)years old.In the TEAS group,percutaneous electrical stimulation at the Neiguan(PC6)and Hegu(L14)acupoints was performed 10 minutes before anesthesia until the operation was completed.In the control group,electrode pads were placed at the same acupoints but without electrical stimulation.Blood samples were collected on preoperative 1 d(T_(1)),at the end of the operation(T_(2)),3 h after the operation(T_(3)),1 d after the operation(T_(4)),and 2 d after the operation(T_(5)).The concentrations of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in serum were determined by enzyme-linked immunosorbent assay(ELISA).The degree of POFS of patients was evaluated by the Visual Analogue Fatigue Score(VAFS).The main indicators of clinical prognosis were statistically analyzed in the two groups.Results At T_(2-5),the concentrations of TNF-αand IL-1βin serum in the two groups were significantly higher than those at T_(1)(all P<0.05);the concentrations of TNF-αin the TEAS group at T_(2-5) were(24.8±2.3)ng/L,(31.6±3.4)ng/L,(28.6±3.1)ng/L,and(26.5±2.1)ng/L,which were significantly lower than those in the control group[(27.7±3.4)ng/L,(38.4±3.7)ng/L,(33.7±2.9)ng/L,and(30.3±2.8)ng/L],the concentrations of IL-1βin the TEAS group at T_(2-5) were(4.5±2.4)pg/ml,(9.3
作者
王鹏浩
孟宪慧
Wang Penghao;Meng Xianhui(Operating Room,Henan Provincial Chest Hospital,Zhengzhou 450008,China)
出处
《国际医药卫生导报》
2021年第10期1428-1432,共5页
International Medicine and Health Guidance News
基金
2018年河南省医学科技攻关计划联合共建项目(2018020564)。
关键词
经皮穴位电刺激
术后疲劳综合征
炎性反应
胸外科手术
Transcutaneous electrical acupoint stimulation
Postoperative fatigue syndrome
Inflammatory response
Thoracic surgery
