Effect Of Transcutaneous Electrical Acupoint Stimulation On Gastrointestinal Function And Inflammatory Cytokines After Laparoscopic Sigmoid Colon And Rectal Cancer Surgery

Objective:To investigate the effects of transcutaneous electrical acupoint stimulation(TEAS)on the recovery of gastrointestinal function and the level of inflammatory cytokines in patients with postoperative laparoscopic sigmoid colon and rectal cancer,so as to verify the reliability of clinical efficacy of TEAS and evaluate its clinical application value in rapid rehabilitation surgery.Methods:From June 2019 to December 2020 in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,a total of 75 patients who underwent laparoscopic radical resection of sigmoid colon or rectal cancer were selected.The anesthesia grades were I-III grades.According to the random number table,they were randomly divided into conventional groups(38 cases)and TEAS group(37 cases):conventional group: Western medicine conventional treatment;TEAS group: Western medicine conventional treatment + TEAS(Bilateral Zusanli,Neiguan,Hegu).The intervention time was 6h postoperatively and D1-D3 days postoperatively(9-10 AM,16-17PM),and lasting for 30 min each time.The time of the first anal exhaust and the first defecation after surgery,the time of the first oral fluid diet and the time of getting out of bed alone were compared respectively between the two groups.The NRS score and abdominal distension scale were used to score the gastrointestinal reactions(abdominal pain,abdominal distension,nausea and vomiting)of postoperative D1-D3 patients.The levels of inflammatory cytokines(IL-6,TNF-α)were recorded before and24 h,48h and 72 h after surgery.The number of cases of postoperative incision infection,pulmonary infection,anastomotic fistula and intestinal obstruction in 2 groups were observed.After discharge,the length of postoperative hospital stay was recorded.Results:1.Baseline data of 2 groups were basically the same without significant difference(P>0.05).2.Observation of postoperative patients with gastrointestinal function related indicators recovery time(h)found that patients with normal group and TEAS postoperative anal exhaust time is for the first time: 41.21 + /-3.66,38.06 + /-5.06,for the first time defecation time is: 97.79 + /-2.72,92.12 + /-3.33,for the first time through the mouth to eat liquid diet for: 69.50 + /-3.97,66.21 4.53 mm,short time TEAS visible contrast group were the conventional group,with statistical difference(P< 0.05).The first time of getting out of bed alone after surgery(h)was 34.12±5.01 in the conventional group and 34.32±5.34 in the TEAS group,and there was no statistical difference between the two groups(P>0.05).3.Comparison of postoperative gastrointestinal response scores between D1-D3 groups showed that the effect of TEAS group on the reduction of postoperative relevant scores was better than that of the conventional group,with statistical difference(P<0.05).4.Preoperative plasma levels of IL-6(5.46±1.74vs5.57±1.30)and TNF-α(10.87±1.84vs10.83±1.40)in TEAS group and conventional group were basically the same,and no difference was observed(P>0.05).Comparing the levels of inflammatory cytokines(IL-6,TNF-α)(NG)among the groups three times(24h,48 h,72h)after surgery,the level of the TEAS group was significantly lower than that of the conventional group,and the difference was statistically significant(P<0.05).5.Comparing the number of cases of postoperative incision infection,pulmonary infection,anastomotic fistula and intestinal obstruction in the two groups,the incidence of TEAS group was significantly lower than the control group,the difference was statistically significant(P<0.05).6.The postoperative hospitalization days of patients(D)were significantly reduced in the TEAS group(8.97±1.57)compared with the conventional group(10.35±1.76),with statistical significance(P<0.05).Conclusion:1.TEAS can effectively improve the gastrointestinal dysfunction of patients after radical laparoscopic sigmoid colon or rectal cancer surgery,promote the quality of postoperative recovery,and relieve the discomfort symptoms of postoperative gastrointestinal reactions.2.TEAS can reduce the level of plasma inflammatory cytokines in patients with postoperative laparoscopic sigmoid colon or rectal cancer,reduce inflammatory response,reduce the incidence of postoperative complications,and shorten the length of postoperative hospital stay,which can be used as a treatment method in accelerated rehabilitation surgery.