Effects Of Transcutaneous Electrical Acupoint Stimulation On Cellular Immunity And Insulin Resistance In Diabetic Patients During Perioperative Period

Objective:To explore the effect of TEAS on lymphocyte subsets,blood sugar and insulin resistance in patients with type 2 diabetes mellitus（T2DM）during perioperative period.Methods:Ninety T2DM patients scheduled for gastrointestinal surgery in our hospital were selected.All patients were randomly divided into two groups:preoperative transcutaneous electrical acupoint stimulation group（group E）and only sticking electrode patch without electricity group（group C）,Four five cases in each group.The patients in both groups were given intravenous general anesthesia and postoperative intravenous analgesia was used in all cases.Group E received electrical stimulation of Hegu（LI 4）and Zusanli（ST 36）for 30 minutes before induction,while group C received electrode patches on corresponding acupoints;Mean blood pressure（MAP）,heart rate（HR）,blood glucose（Glu）,insulin（INS）,T lymphocyte subset（CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺）were recorded before electrical stimulation（T₀）,30 minutes after the beginning of operation（T₁）,at the end of the operation（T₂）and 24 hours after surgery（T₃）.Results:There was no significant difference in preoperative general condition,intraoperative infusion volume,blood loss and anesthesia maintenance drug dosage.（P<0.05）.Compared with T₀,Glu,INS and insulin resistance index（IRI）were significantly increased and insulin sensitivity index（ISI）was significantly decreased in group C at T₁and T₂（P<0.05）;Compared with T₀,INS decreased in group E at T₁and T₂,IRI decreased and ISI increased in group E at T₁（P<0.05）;Compared with T₀,MAP and HR in E group were decreased at T₁-T₃（P<0.05）;Compared with group C,Glu,INS,IRI,MAP and HR were decreased and ISI was increased in group E at T₁and T₂（P<0.05）;There was no significant difference in Glu and INS at T3 between the two groups.Compared with T₀,CD3⁺and CD4⁺were significantly decreased in group C at T₁-T₃,while CD3⁺,CD4⁺and CD4⁺/CD8⁺were increased in group E（P<0.05）.Compared with group C,CD3⁺,CD4⁺and CD4⁺/CD8⁺in group E were higher at T₁-T₃（P<0.05）;There was no statistical difference in CD8⁺between the two groups.Conclusion:Transcutaneous acupoint electrical stimulation can improve the immune defense ability of T2DM patients during perioperative period,reduce the changes of blood glucose caused by stress,improve insulin resistance,stabilize the internal environment of diabetic patients,and promote postoperative recovery.