| Research goals Selecting Zusanli and Neiguan acupoint with transcutaneous acupoint electrical stimulation to interfer postoperative gastrointestinal dysfunction,we optimized the frequency of parameters,and observed the effect of different frequency of TEAS on postoperative gastrointestinalrecovery,so as to improve the clinical efficacy.Methods:69 cases of celiac surgery from April 2016 to February 2018 were selected from the Department of general surgery of the Second Affiliated Hospital of Nanjing University of Chinese Medicine.69 patients abdominal surgery were divided into three groups according to the proportion of 1:1:1 random seq generation by SPSS22.0 software:group 2Hz,group 25Hz and control group.All patients were given routine nursing,fasting,routine fluid replacement,gastrointestinal decompression and anti-inflammatory treatment.2Hz group received bilateral Zu Sanli and Nei Guan Points 6 hours after operation,and connected with acupoint stimulator.The frequency was 2Hz,the pulse width 0.6ms,the current intensity 10mA continuous wave stimulation,2 times a day,60 min each time for 3 days;25Hz group:the same as 2Hz group,but the frequency was 25Hz;the control group:the same 2Hz group,the current intensity was 0mA.6 hours after the operation monitoring and record the postoperative anal exhaust defecation time,abdominal pressure,pain score and clinical symptom score changes,and compare the preoperative 2D and postoperative 4D fasting procalcitonin(PCT),high sensitive C reactive protein(CRP)and gastrin(GAS)and motilin(MTL)value.The database is set up,and the data obtained by SPSS22.0 software are compared and analyzed.Results:1.Baseline data:after statistical analysis,there was no statistically significant difference in the general information(gender,age,body mass index,operative type,operative time and intraoperative blood loss)between the three groups(P>0.05).2.For the first time anal exhaust defecation time:between the three groups in the first exhaust and defecation time difference,2Hz group was the first exhaust and defecation time were(33.17 + 9.01)h and(54.39 + 10.20)h,25Hz group(40.61 + 8.37)H and(61.87 + 12.97)h,the control group only for(50.30 + 12.54)h and(76.26± 19.72)h,three in group 2Hz(P<0.05)has obvious advantages.3.Markers of inflammation:preoperative 2D PCT value and CRP value between the three groups had no significant difference(P>0.05),4D after operation in three groups were significantly i significantly and the difference between groups(P<0.05)in 2Hz group compared to the other two groups,25Hz group compared to the control group before and after treatment in PCT and the difference in CRP are significantly different(P<0.05).To sum up,TEAS can significantly reduce the inflammatory response to the body caused by surgical trauma,and 2Hz is more effective than 25Hz.4.The gastrin and motilin value:The gastrin and motilin in three groups of 2D under fasting gastrin and motilin levels were not statistically significant(P>0.05)of all patients after gastrin and motilin content 4D were significantly decreased and the preoperative difference between groups(P<0.05)in 2Hz group compared to the other two groups,compared to the 25Hz group the control group before and after the operation of gastrin and motilin in difference(P<0.05)have significant effect,indicating that TEAS can significantly improve the postoperative gastrointestinal hormone levels,2Hz has better effect than 25Hz.5.Intraperitoneal pressure value:Intraperitoneal pressure value was measured indirectly by bladder pathway.The three groups before treatment of intra-abdominal pressure had no significant difference(P>0.05),after the treatment of intra-abdominal pressure than before treatment significantly decreased significantly and the difference between groups(P<0.05),2Hz group before and after treatment of intra abdominal pressure(6.43 +2.52)mmHg,25Hz group(4.83 + 2.42)mmHg control.Group(3.48 + 1.90)mmHg,TEAS two groups were significantly different compared with control group(P<0.05),2Hz group compared to the other two groups,25Hz group compared to the control group before and after treatment in intra-abdominal pressure difference were significant effect(P<0.05)indicated that TEAS can significantly reduce postoperative intra-abdominal pressure,2Hz the effect of 25Hz is better.6.Pain:Pain score by surgery commonly used Prince-Henry standards are divided into 5 levels,and pain scores before and after treatment of the three groups after treatment score had significant difference(P<0.05),2Hz group compared to the other two groups,25Hz group compared to the control group.The score in the treatment of pain before and after the treatment effect is significant(P<0.05).TEAS can significantly relieve postoperative pain,curative effect is better than 25Hz 2Hz.7.Symptom score:There was no significant difference between the three groups before treatment(P>0.05),and the difference of score and score difference after treatment was significant(P<0.05).Compared with the rest two groups and 25Hz group,the 2Hz group had a significant effect in comparison with the control group before and after treatment(P<0.05),indicating that TEAS can significantly improve the clinical symptoms of postoperative gastrointestinal dysfunction,and 2Hz is better than 25Hz.8.The effect of the index:Index of three group average effect respectively(86.68 + 12.69)%and(73.35 +17.17)%and(53.75 + 13.07)%,with obvious difference between groups(P<0.05)effect of 2Hz group was significantly better than group 25Hz(P<0.05),2Hz group compared to the other two groups,compared witl the 25Hz group in the control group were significantly different(P<0.05),TEAS treatment of postoperative gastrointestinal dysfunction compared with conventional treatment has obvious advantages,2Hz has effect than 25Hz.9.in the treatment of grade and clinical significant efficiency:2Hz Group 8 cases were cured,13 markedly effective in 2 cases,the clinical effective rate was 91.3%,25Hz group 3 cases were cured,12 markedly effective in 8 cases,the clinical effective rate was 65.2%,control group 0 cases were cured,3 were cured,20 cases were effective,clinically significant efficiency of 13%groups of significant di(x2=32.209,P<0.05),2Hz group compared to the other two groups,25Hz group compared to the group were significantly different(P<0.05).Safety index evaluation:In group 2Hz,there was a case of skin pruritus.Patients indicated that they coulc tolerate no stopping treatment and drug intervention.The other patients had no adverse reactions such as skin redness and skin ulceration.Conclusion:TEAS selected Zusanli and Neiguan Points in the treatment of postoperative gastrointestina dysfunction is more effective than conventional treatment,and there is no obvious adverse reaction.2Hz i much better than 25Hz. |
PDF Full Text Request