电刺激双侧足三里对分娩后孕妇胃肠功能恢复的影响及机制研究
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摘要
目的:考察电刺激双侧足三里对分娩后孕妇胃肠功能恢复的影响及可能的机制。方法:选择2016年1月—2017年1月医院妇产科行剖腹产的产妇80例,患者被随机分为对照组和实验组,每组40例。对照组接受术后常规治疗,实验组接受术后常规治疗+双侧足三里电刺激。检测患者肠鸣音恢复正常时间、首次肛口排气时间、首次排便时间、腹痛评分、腹胀评分、胃肠功能时间、胃动素、胃泌素和内皮素。结果:治疗后,实验组肠鸣音恢复时间、首次排气时间和首次排便时间显著低于对照组(t=2.87,P<0.01;t=3.12,P<0.01;t=3.52,P<0.01);实验组48 h恢复正常数显著高于对照组(χ~2=4.02,P<0.05);实验组腹痛评分显著低于对照组(t=5.70,P<0.01);实验组腹涨评分显著高于对照组(t=5.69,P<0.01);实验组胃动素和胃泌素显著高于对照组(t=5.70,P<0.01;t=20.89,P<0.01);实验组内皮素显著低于对照组(t=8.43,P<0.01)。结论:电刺激双侧足三里能促进分娩后孕妇胃肠功能的恢复,降低腹胀和腹痛的发生率,其作用机制可能和增加血清胃动素和胃泌素,减少内皮素有关。
Objective: To investigate the effect of electrical stimulation at bilateral Zusanli(ST36) on the recovery of gastrointestinal function and the possible mechanism after delivery. Methods: Eighty cases of cesarean section from January 2016 to January 2017 in our obstetrics and gynecology department were selected and randomly divided into control group and experimental group, 40 cases in each group. The control group received routine postoperative treatment and the experimental group received routine postoperative treatment and electrical stimulation at bilateral Zusanli(ST36). We detected the recovery time of normal bowel sounds,the first anal vent time, the first defecation time, the abdominal pain score, the abdominal distention score, the gastrointestinal function time, the motilin, gastrin and endothelin were measured. Results: After treatment, the recovery time of normal bowel sounds, the first exhaust time and the first defecation time in the experimental group were significantly lower than those of the control group(t=2.87, P<0.01; t=3.12, P<0.01; t=3.52, P<0.01). The number of 48 h returned to normal in the experimental group was significantly higher than that in the control group(χ~2=4.02, P<0.05). The abdominal pain score in the experimental group was significantly lower than that in the control group(t=5.70, P<0.01). The abdominal distension score in the experimental group was significantly higher than that in the control group(t=5.69, P<0.01). Motilin and gastrin in the experimental group were significantly higher than those in the control group(t=5.70, P<0.01, t=20.89, P<0.01). The endothelin in the experimental group was significantly lower than that in the control group(t=8.43, P<0.01). Conclusions: Electric stimulation at bilateral Zusanli(ST36) can promote the recovery of gastrointestinal function in pregnant women after delivery, reduce the incidence of abdominal distention and abdominal pain, and the mechanism may be associated with increasing serum motilin and gastrin and reducing endothelin.
Objective: To investigate the effect of electrical stimulation at bilateral Zusanli(ST36) on the recovery of gastrointestinal function and the possible mechanism after delivery. Methods: Eighty cases of cesarean section from January 2016 to January 2017 in our obstetrics and gynecology department were selected and randomly divided into control group and experimental group, 40 cases in each group. The control group received routine postoperative treatment and the experimental group received routine postoperative treatment and electrical stimulation at bilateral Zusanli(ST36). We detected the recovery time of normal bowel sounds,the first anal vent time, the first defecation time, the abdominal pain score, the abdominal distention score, the gastrointestinal function time, the motilin, gastrin and endothelin were measured. Results: After treatment, the recovery time of normal bowel sounds, the first exhaust time and the first defecation time in the experimental group were significantly lower than those of the control group(t=2.87, P<0.01; t=3.12, P<0.01; t=3.52, P<0.01). The number of 48 h returned to normal in the experimental group was significantly higher than that in the control group(χ~2=4.02, P<0.05). The abdominal pain score in the experimental group was significantly lower than that in the control group(t=5.70, P<0.01). The abdominal distension score in the experimental group was significantly higher than that in the control group(t=5.69, P<0.01). Motilin and gastrin in the experimental group were significantly higher than those in the control group(t=5.70, P<0.01, t=20.89, P<0.01). The endothelin in the experimental group was significantly lower than that in the control group(t=8.43, P<0.01). Conclusions: Electric stimulation at bilateral Zusanli(ST36) can promote the recovery of gastrointestinal function in pregnant women after delivery, reduce the incidence of abdominal distention and abdominal pain, and the mechanism may be associated with increasing serum motilin and gastrin and reducing endothelin.
引文
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[10] 李方,高纺.针刺“足三里”穴干预胃肠功能紊乱-腹泻模型大鼠胃肠激素GAS、MTL水平的影响[J].浙江中医药大学学报,2017(4):271-273,277.
[11] 彭秀晴,李雅静,卢金菊.泌尿外科术后足三里按摩促进胃肠功能恢复的临床研究[J].河北医药,2009(2):191-192.
[12] 梁彩燕.足三里按摩联合早期假进食促进老年胃肠患者术后胃肠功能恢复的临床观察[J].国际护理学杂志,2017(23):3172-3176.
[13] 邓丽金,郑丽维,李壮苗, 等.足三里择时穴位按摩对COPD肺心病胃肠功能的影响[J].护理学杂志,2012(11):14-15.
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[17] 朱利利,杨丽明,刘秋萍, 等.足三里穴位埋线促进腹部术后胃肠功能恢复的效果研究[J].中国医药导报,2010(18):25-26.
[18] 王晓燕,王世军,吴富东.电针足三里穴对胃肠功能紊乱大鼠5-HT的影响[J].针灸临床杂志,2012(9):51-53,75.
[19] 王宽宇,陈静,孙晓龙, 等.电针足三里、上巨虚对腹部术后胃肠功能的影响[J].针灸临床杂志,2007(12):19-20.
[20] 常小荣,严洁,林亚平, 等.针刺足三里对功能性消化不良患者血浆胃肠激素的影响[J].中国中西医结合消化杂志,2001(5):283-284.
[21] 邓晶晶,袁青.针刺促进结直肠癌术后胃肠动力恢复的miRNA相关机制探讨[J].广州中医药大学学报,2018(1):74-79.
[22] 汪洋,王新乐.足三里穴位注射在改善消化道手术后胃肠功能中的应用价值[J].现代消化及介入诊疗,2015(2):147-148.
[23] 刘琤琤,吴莉,李敏, 等.辰时中药足浴联合艾灸足三里对腹腔镜胆囊切除患者术后胃肠功能的影响[J].护理学报,2017(15):60-63.
[24] 陈德庆.足三里、内关穴针刺治疗胃肠肿瘤化疗后胃肠道反应的临床观察[J].中国社区医师,2015(9):80-81.
[25] 赵江花,张国清.足三里穴位注射格拉司琼预防化疗胃肠反应的疗效观察[J].中国美容医学,2012(12):309.
[2] 王晶晶,孔祥照,张晓璇.针刺足三里对脓毒症胃肠功能障碍患者腹内压的影响[J].中国中医急症,2012(11):1834-1835.
[3] 刘怡素,李佳.芒硝袋外敷联合足三里刺激对肝门阻断患者术后胃肠道功能影响的应用现状[J].海南医学,2017(11):1814-1816.
[4] 胡正昌,罗超兰.足三里应用于腹部术后胃肠功能恢复的Meta分析[J].中国中医药科技,2015(4):471-473.
[5] 胡妍妍.艾灸联合穴位按摩足三里对老年食管癌患者术后早期胃肠功能恢复的影响[J].国际护理学杂志,2017(8):1045-1047.
[6] 冼丽娜,杨远征,陈伟.VitB1联合新斯的明足三里注射治疗重症急性胰腺炎胃肠动力障碍的作用[J].海南医学,2017(24):4059-4060.
[7] 张建军.足三里温针灸预防吲哚美辛胃肠道损伤40例[J].陕西中医,2003(9):834-835.
[8] 侯晓倩.腹立通膏联合穴位电针及贴敷治疗腹部术后胃肠功能障碍[J].长春中医药大学学报,2017(6):942-944.
[9] 何国栋,牛伟新,刘寒, 等.针刺足三里调控胃肠动力机制的实验研究[J].中华消化杂志,2007(11):748-751.
[10] 李方,高纺.针刺“足三里”穴干预胃肠功能紊乱-腹泻模型大鼠胃肠激素GAS、MTL水平的影响[J].浙江中医药大学学报,2017(4):271-273,277.
[11] 彭秀晴,李雅静,卢金菊.泌尿外科术后足三里按摩促进胃肠功能恢复的临床研究[J].河北医药,2009(2):191-192.
[12] 梁彩燕.足三里按摩联合早期假进食促进老年胃肠患者术后胃肠功能恢复的临床观察[J].国际护理学杂志,2017(23):3172-3176.
[13] 邓丽金,郑丽维,李壮苗, 等.足三里择时穴位按摩对COPD肺心病胃肠功能的影响[J].护理学杂志,2012(11):14-15.
[14] 王芳.足三里穴位注射维生素B1对颅脑损伤术后胃肠功能恢复的影响[J].现代中西医结合杂志,2017(19):2136-2138.
[15] 丁艳红,古坤德,魏海玲, 等.足三里、内关穴针刺治疗胃肠肿瘤化疗后胃肠道反应的效果观察[J].护理实践与研究,2015(12):84-85.
[16] 胡森,王磊,宋琪, 等.电针足三里兴奋胆碱能通路对烫伤大鼠胃肠黏膜血流量和肠动力的影响[J].中国中西医结合急救杂志,2009(2):79-81.
[17] 朱利利,杨丽明,刘秋萍, 等.足三里穴位埋线促进腹部术后胃肠功能恢复的效果研究[J].中国医药导报,2010(18):25-26.
[18] 王晓燕,王世军,吴富东.电针足三里穴对胃肠功能紊乱大鼠5-HT的影响[J].针灸临床杂志,2012(9):51-53,75.
[19] 王宽宇,陈静,孙晓龙, 等.电针足三里、上巨虚对腹部术后胃肠功能的影响[J].针灸临床杂志,2007(12):19-20.
[20] 常小荣,严洁,林亚平, 等.针刺足三里对功能性消化不良患者血浆胃肠激素的影响[J].中国中西医结合消化杂志,2001(5):283-284.
[21] 邓晶晶,袁青.针刺促进结直肠癌术后胃肠动力恢复的miRNA相关机制探讨[J].广州中医药大学学报,2018(1):74-79.
[22] 汪洋,王新乐.足三里穴位注射在改善消化道手术后胃肠功能中的应用价值[J].现代消化及介入诊疗,2015(2):147-148.
[23] 刘琤琤,吴莉,李敏, 等.辰时中药足浴联合艾灸足三里对腹腔镜胆囊切除患者术后胃肠功能的影响[J].护理学报,2017(15):60-63.
[24] 陈德庆.足三里、内关穴针刺治疗胃肠肿瘤化疗后胃肠道反应的临床观察[J].中国社区医师,2015(9):80-81.
[25] 赵江花,张国清.足三里穴位注射格拉司琼预防化疗胃肠反应的疗效观察[J].中国美容医学,2012(12):309.