电针治疗对老年胃肠道术后患者认知功能障碍及外周炎症因子的影响

赵娜; 吴祥; 吴秀青; 张瑞; 谢央央; 张州艳

doi:10.16766/j.cnki.issn.1674-4152.002981

电针治疗对老年胃肠道术后患者认知功能障碍及外周炎症因子的影响

doi: 10.16766/j.cnki.issn.1674-4152.002981

赵娜^1, ,,
吴祥¹,
吴秀青¹,
张瑞¹,
谢央央²,
张州艳²

1.
宁波大学医学院附属医院麻醉科，浙江宁波 315020
2.
宁波大学医学院附属医院手术室

基金项目:

浙江省中医药科技计划项目 2021ZB264

详细信息

通讯作者:
赵娜，E-mail：zhnbsh516@163.com

中图分类号: R619 R245.31
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出版历程
- 收稿日期: 2022-11-18

Effects of electroacupuncture on postoperative cognitive dysfunction and peripheral inflammatory factors in elderly patients after gastrointestinal surgery

1.
Department of Anesthesiology, Affiliated Hospital of Ningbo University School of Medicine, Ningbo, Zhejiang 315020, China

摘要

摘要: 目的老年胃肠道术后认知功能障碍(POCD)高发，外周炎症反应明显，为降低老年胃肠道术后POCD及外周炎症反应，本研究在老年胃肠道术后采用电针治疗，以期降低患者术后POCD及外周炎症因子水平。方法选择宁波大学医学院附属医院2020年2月—2022年3月拟行胃肠道手术治疗的200例老年患者，采用随机数字表法将患者分为针刺组和对照组，每组100例；对照组术后予以常规基础支持治疗，同时予以抗感染、补液等支持治疗，针刺组在对照组的基础上予以电针治疗，治疗后比较临床疗效。结果治疗后，针刺组听觉言语学习测验评分为(58.32±1.47)分、画钟测试评分为(6.08±0.35)分，高于对照组的(57.74±1.28)分、(5.89±0.40)分(均P < 0.05)，连线测验耗时为(60.01±12.09)s、Stroop颜色词干扰测试耗时为(25.98±7.00)s，低于对照组的(63.97±14.21)s、(28.79±7.35)s，差异有统计学意义(均P < 0.05)；治疗后，针刺组外周炎症因子指标水平均低于对照组(P < 0.05)；术后1~3 d针刺组疼痛评分低于对照组(P < 0.05)，术后4~7 d组间比较差异无统计学意义(P>0.05)；治疗后，针刺组POCD发生率低于对照组(P < 0.05)。结论术后电针治疗能促进老年术后患者认知功能恢复，缓解患者早期疼痛程度，降低外周炎症因子水平及术后POCD发生率。
- 电针 /
- 胃肠道手术 /
- 认知功能障碍 /
- 外周炎症因子
Abstract: Objective To treat elderly patients with gastrointestinal surgery with electroacupuncture, and to explore its effect on postoperative cognitive dysfunction (POCD) and the levels of peripheral inflammatory factors. Methods A total of 200 elderly patients who underwent gastrointestinal surgery under general anesthesia from February 2020 to March 2022 in the Affiliated Hospital of Ningbo University School of Medicine were selected, and the patients were divided into acupuncture group and control group by random number table method, with 100 cases in each group. The control group received routine basic supportive treatment such as oxygen inhalation ECG monitoring, and symptomatic supportive treatment such as infection prevention, hemostasis and fluid supplementation, and the acupuncture group received electroacupuncture on the basis of the control group. After treatment, the clinical efficacy was compared between the two groups. Results After treatment, the scores of auditory and verbal learning test in the acupuncture group was (58.32±1.47) points, and the score of clock drawing test was (6.08±0.35) points, which were higher than those in the control group [(57.74±1.28) points and (5.89±0.40) points] (all P < 0.05). The connection test time was (60.01±12.09)s, and the Stroop color word interference test time was (25.98±7.00)s, which was lower than those in the control group [(63.97±14.21)s and (28.79±7.35)s] (all P < 0.05). After treatment, the levels of peripheral inflammatory factors in the acupuncture group were lower than those in the control group (P < 0.05). The pain scores in the acupuncture group 1-3 d after operation were lower than those in the control group (P < 0.05), there was no significant difference between the groups 4-7 d after operation (P>0.05). After treatment, the incidence of POCD in the acupuncture group was lower than that in the control group (P < 0.05). Conclusion Postoperative electroacupuncture can promote the recovery of cognitive function in elderly patients after surgery, relieve the early pain of patients, reduce the level of peripheral inflammatory factors and the incidence of postoperative POCD.
- Electroacupuncture /
- Gastrointestinal surgery /
- Cognitive dysfunction /
- Peripheral inflammatory factors
利益冲突 无

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表 1 2组老年患者认知功能比较(x±s)

Table 1. Comparison of cognitive function between the two groups of patients(x±s)

组别	例数	AVLT(分)		TMT(s)		CDT(分)		SCWT(s)
组别	例数	术前1 d	术后7 d	前1 d	术后7 d	术前1 d	术后7 d	术前1 d	术后7 d
针刺组	100	54.74±1.33	58.32±1.47^a	66.43±20.17	60.01±12.09^a	5.33±1.00	6.08±0.35^a	30.42±9.76	25.98±7.00^a
对照组	100	55.00±0.84	57.74±1.28^a	65.56±18.34	63.97±14.21^a	5.28±1.12	5.89±0.40^a	31.61±9.05	28.79±7.35^a
t值		1.653	2.976	0.319	2.123	0.333	3.575	0.894	2.768
P值		0.100	0.003	0.750	0.035	0.739	<0.001	0.372	0.006
注：与同组治疗前比较，^aP<0.05。

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表 2 2组老年患者外周炎症因子比较(x±s)

Table 2. Comparison of peripheral inflammatory factors in two groups of patients(x±s)

组别	例数	TNF-α(ng/L)		IL-1β(ng/mL)		IL-6(ng/L)		CRP(mg/L)
组别	例数	术前1 d	术后7 d	术前1 d	术后7 d	术前1 d	术后7 d	术前1 d	术后7 d
针刺组	100	10.83±2.46	2.72±0.73^a	24.56±4.34	12.15±3.25^a	35.12±3.31	15.81±4.58^a	32.27±5.59	18.26±4.56^a
对照组	100	10.94±2.41	3.04±1.01^a	23.74±4.62	13.58±3.25^a	35.21±3.34	17.59±4.16^a	32.54±5.83	20.71±5.82^a
t值		0.319	2.568	1.294	3.111	0.191	2.877	0.334	3.314
P值		0.750	0.011	0.197	0.002	0.848	0.004	0.739	0.001
注：与同组治疗前比较，^aP<0.05。

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表 3 2组老年患者疼痛评分比较(x±s，分)

Table 3. Comparison of pain scores between the two groups (x±s, points)

组别	例数	术后1 d	术后2 d	术后3 d	术后4 d	术后5 d	术后6 d	术后7 d
针刺组	100	3.21±0.85	2.70±0.79^a	2.01±0.56^a	1.68±0.51^a	1.41±0.32^a	1.40±0.41^a	1.35±0.39^a
对照组	100	3.45±0.71	3.01±0.87^a	2.25±0.64^a	1.79±0.52^a	1.49±0.40^a	1.43±0.30^a	1.34±0.41^a
t值		2.167	2.638	2.822	1.510	1.562	0.591	0.177
P值		0.031	0.009	0.005	0.133	0.120	0.556	0.860
注：与同组术后1 d比较，^aP<0.05。

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