腕踝针配合耳穴贴压对老年胃肠癌患者术后疼痛和肠胃功能的影响

The effect of wrist-ankle acupuncture combined with ear acupoint pressing on postoperative pain and gastrointestinal function in elderly patients with gastrointestinal cancer

中文关键词: 老年  胃肠癌  术后恢复  腕踝针  耳穴贴压

英文关键词: elderly  gastrointestinal cancer  postoperative recovery  wrist-ankle acupuncture  ear acupoint pressing

中文摘要:

      目的 观察腕踝针配合耳穴贴压对老年胃肠癌患者术后恢复的影响.方法 选取2021 年6 月—2023 年6 月于江苏省中医院拟进行手术的老年胃肠癌患者70 例,按照数字表法随机分为观察组(n =35)及对照组(n =35).术后,对照组给予耳穴贴压治疗,观察组行腕踝针联合耳穴贴压治疗,2 组均连续治疗7d.观察并比较2 组患者治疗效果、疼痛程度[术前(T0)、术后24 h(T1)、术后48 h(T2)及术后72 h(T3)采用疼痛视觉模拟量表(VAS)进行评分]、疼痛介质[血清β-内啡肽(β-ep)、P物质(SP)和5-羟色胺(5-HT)]水平变化、胃癌及肠癌患者肠胃功能恢复时间及不良反应发生情况.结果 治疗后,观察组治疗总有效率高于对照组(94.29%vs 80.00%,P＜0.05);与T0 相比,2 组T1～T3 的VAS评分均明显降低(P＜0.05),且在T2 和T3 时,观察组VAS评分低于对照组(P＜0.05).治疗前,2 组血清SP、β-ep及5-HT水平差异均无统计学意义(P＞0.05);与同组治疗前比较,治疗后2 组血清SP水平均降低(P＜0.05),且治疗后观察组血清SP水平低于对照组(P＜0.05);与同组治疗前比较,2 组血清β-ep、5-HT水平均升高(P＜0.05),且治疗后观察组血清β-ep、5-HT水平均高于对照组(P＜0.05).观察组胃癌患者术后胃肠功能各指标恢复时间均少于对照组(P＜0.05);观察组肠癌患者术后胃肠功能各指标恢复时间均少于对照组(P＜0.05).2 组不良反应发生率差异无统计学意义(P＞0.05).结论 腕踝针配合耳穴贴压可有效减轻老年胃肠癌患者术后疼痛,降低疼痛介质水平,促进患者肠胃功恢复.

英文摘要:

      Objective To observe the effect of wrist?ankle acupuncture combined with ear acupoint pressing on postop? erative recovery of elderly patients with gastrointestinal cancer. Methods A total of 70 elderly patients with gastrointestinal cancer who scheduled to undergo surgery in Traditional Chinese Medicine Hospital of Jiangsu Province from June 2021 to June 2023 were selected and randomly divided into observation group (n =35) and control group (n =35) according to numerical table method. After surgery, the control group received ear acupoint pressing treatment, while the observation group received wrist?ankle acupuncture combined with ear acupoint pressing treatment. Both groups received continuous treatment for 7 days. The therapeutic effect, pain degree [scores of visual analogue scale (VAS) at preoperative (T0), postoperative 24 h (T1), postoperative 48 h (T2) and postoperative 72 h (T3)], the changes of pain mediators [serum β?endorphin (β?ep), substance P (SP) and 5?hydroxytryptamine (5?HT)], the recovery time of gastrointestinal function in patients with gastric cancer and intes? tinal cancer, as well as the incidence of adverse reactions were observed and compared between the two groups. Results After treatment, the total effective rate of the observation group was higher than that of the control group (94. 29% vs 80. 00% , P < 0. 05). Compared with at T0, VAS scores of both groups were lower at T1~T3 (P <0. 05), and the VAS score of the obser? vation group was significantly lower than that of the control group at T2 and T3 (P <0. 05). Before treatment, there was no significant difference in the levels of SP, β?ep and 5?HT between the two groups (P >0. 05). Compared with the same group before treatment, the serum SP level of the two groups decreased after treatment (P <0. 05), and the serum SP level of the ob? servation group was lower than that of the control group (P <0. 05); compared with the same group before treatment, the lev?els of serum β?ep and 5?HT levels of the two groups increased after treatment(P <0. 05), and the levels of serum β?ep and 5? HT levels of the observation group were higher than those of the control group (P <0. 05). The recovery time of gastrointesti? nal function indexes in patients with gastric cancer and those with intestinal cancer in the observation group were shorter than those in the control group (P <0. 05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0. 05). Conclusion The combination of wrist?ankle acupuncture with ear acupoint pressing therapy can effective? ly relieve postoperative pain, reduce levels of pain mediators and promote the recovery of gastrointestinal function in elderly pa? tients with gastrointestinal cancer.