OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with electroacupuncture (EA) on rehabilitation after abdominal surgery.
METHODS: A total of 320 patients undergoing abdominal surgery were randomly divided into a combination group (80 cases), a TEAS group (80 cases, 1 case discontinued), an EA group (80 cases, 1 case discontinued) and a control group (80 cases, 1 case discontinued). The patients in the control group received enhance recovery after surgery (ERAS) standardized perioperative management. On the basis of the treatment in the control group, the TEAS group was treated with TEAS at Liangmen (ST 21) and Daheng (SP 15); the EA group was treated with EA at Neiguan (PC 6), Hegu (LI 4), Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39); the combination group was treated with TEAS combined with EA, with continuous wave, 2-5 Hz in frequency, and the intensity was tolerable to the patients, 30 min each time, once a day, from the first day after surgery, until the anus resumed spontaneous defecation and the oral intake of solid food was tolerated. The gastrointestinal-2 (GI-2) time, first exhaust time, first defecation time, first tolerance of oral intake of solid food time, time of first get out of bed and hospital stay were observed in all the groups; the pain visual analogue scale (VAS) score and incidence rates of nausea and vomiting 1, 2, 3 days after surgery were compared in all the groups; after treatment, the acceptability of each treatment was evaluated by patients in each group.
RESULTS: Compared with the control group, the GI-2 time, first exhaust time, first defecation time, first tolerance of oral intake of solid food time were shortened (P<0.05), the VAS scores 2, 3 days after surgery were decreased (P<0.05) in the combination group, the TEAS group and the EA group; those in the combination group were shorter and lower than the TEAS group and the EA group (P<0.05). Compared with the control group, the time of hospital stay in the combination group, the TEAS group and the EA group were shortened (P<0.05), and that in the combination group was shorter than the TEAS group (P<0.05).
CONCLUSIONS: TEAS combined with EA can accelerate the recovery of gastrointestinal function in patients after abdominal surgery, relieve postoperative pain, and shorten hospital stay.
目的:观察经皮穴位电刺激联合电针对腹部手术后康复的影响。方法:将320例接受腹部手术的患者随机分为经皮穴位电刺激联合电针组(联合组,80例)、经皮穴位电刺激组(80例,中止1例)、电针组(80例,中止1例)和对照组(80例,中止1例)。对照组患者接受加速康复外科(ERAS)标准化围手术期管理。在对照组治疗基础上,经皮穴位电刺激组采用经皮穴位电刺激梁门、大横;电针组采用电针刺激内关、合谷、足三里、上巨虚、下巨虚;联合组采用经皮穴位电刺激联合电针治疗。予连续波,频率2~5 Hz,强度以患者能耐受为度,每次30 min,每日1次,自术后第1天开始,至肛门恢复自主排便,并能耐受经口进食固体食物为止。观察各组患者首次排便时间和耐受经口进食固体食物时间的综合结果(GI-2)时间、首次排气时间、首次排便时间、首次耐受经口进食固体食物时间、首次下床时间、住院天数,比较各组患者术后1、2、3 d疼痛视觉模拟量表(VAS)评分及恶心、呕吐发生率,治疗结束后评价患者对每种治疗方法的接受性。结果:与对照组比较,联合组、经皮穴位电刺激组、电针组GI-2时间、首次排气时间、首次排便时间、首次耐受经口进食固体食物时间缩短(P<0.05),术后2、3 d疼痛VAS评分降低(P<0.05),且联合组短于、低于经皮穴位电刺激组、电针组(P<0.05)。与对照组比较,联合组、经皮穴位电刺激组、电针组住院天数缩短(P<0.05),且联合组短于经皮穴位电刺激组(P<0.05)。结论:经皮穴位电刺激联合电针能加速腹部手术后患者胃肠功能的恢复,减轻术后疼痛,缩短住院时间。.