陈辉等

[摘要] 目的 探讨早期电针下合穴对肠道术后胃肠功能恢复的影响。 方法 将2012年1月～2014年9月浙江医院收治的行开腹胃肠道手术患者86例随机分为治疗组和对照组，各43例。对照组采用常规禁食、胃肠减压、补液、抗感染等对症治疗，治疗组于术后24 h内给予电针下合穴治疗，比较两组临床疗效、胃肠功能恢复情况及血浆胃泌素水平变化。 结果 治疗组临床总有效率为90.7%，显著高于对照组（74.4%）（P < 0.05）；治疗组患者肠鸣音恢复时间、排气时间、排便时间及进食时间均较对照组患者明显缩短（P < 0.05）；术后1、2 d两组血浆胃泌素水平均明显下降，治疗组术后2、3 d血浆胃泌素水平均明显高于对照组（P < 0.05）。 结论 早期电针下合穴治疗肠道术后胃肠功能紊乱，可改善血清胃泌素水平，促进胃肠功能早期恢复。

[关键词] 肠道手术；电针治疗；下合穴；胃肠功能

[中图分类号] R269.56 [文献标识码] A [文章编号] 1673-7210（2015）05（c）-0143-04

[Abstract] Objective To explore influence of early electrical acupuncture for lower confluent acupoint on the recovery of gastrointestinal function in post-operative intestinal surgery patients. Methods 86 cases of post-operative intestinal surgery patients who received intestinal surgery from January 2012 to September 2014 in Zhejiang Hospital were randomly divided into treatment group and control group， with 43 cases in each group. Control group was given normal treatment including routine fasting， gastrointestinal decompression， fluid infusion， anti-infection， and treatment group was given electrical acupuncture on lower confluent acupoint within 24 h after surgery additionally. The clinical effect， postoperative recovery of gastrointestinal functions， level of plasma gastrin between two groups were compared. Results The clinical total effectivel rate in treatment group was 90.7%， which was significantly higher than that in control group （74.4%） （P < 0.05）. Compared with control group， the bowel sound recovery time， exhaust time and defecate time， beginning taking food time in treatment group were reduced remarkably （P < 0.05）. The levels of plasma gastrin in both groups were significantly reduced at 1st and 2nd day after surgery， and the levels in treatment group at 2nd and 3rd day after surgery were significantly higher than those in control group （P < 0.05）. Conclusion Early electrical acupuncture for lower confluent acupoint in the treatment of gastrointestinal dysfunctionon in post-operative intestinal surgery can improve the level of serum gastrin， promote early recovery of gastrointestinal function.

[Key words] Intestinal surgery； Electrical acupuncture； Lower confluent acupoint； Gastrointestinal function

肠道手术是外科最常见的手术之一，由于手术对胃肠道的激惹、牵拉及麻醉等原因，大多数患者术后可出现不同程度的胃肠功能紊乱，且恢复时间较长。从时间上讲，胃动力、小肠动力、结肠动力分别在术后24、48、72 h未恢复，并出现腹胀、恶心呕吐、矢气不通等症状、体征者即可视为“肠道术后胃肠功能障碍”，不仅影响术后机体的康复，还会明显增加患者术后住院天数与治疗费用，导致不必要的医患纠纷，给医患双方带来心理负担。加快肠道术后胃肠功能恢复，不仅有助于患者早期进食，避免水、电解质、酸碱平衡紊乱，还可有效降低术后肠胀气、肠粘连、肠梗阻等多种并发症的发生，对患者的康复和预后至关重要[1]。

目前，西医多采用禁食、胃肠减压、胃肠动力药物等治疗，但效果并不理想且副作用明显，而祖国医学在术后胃肠功能紊乱治疗上具有独到的优势，如针灸、电针及中药内服外用等均获得了较好的临床疗效[2-3]。……