摘要
目的:探讨电针缓解肠镜检查患者疼痛的可能机制。方法:60例肠镜检查患者随机分为电针组和对照组各30例。电针组于肠镜检查前30 min选右侧足三里、上巨虚,左侧阴陵泉、三阴交以电针刺激,同时针刺双侧合谷;对照组未予任何处理。监测患者平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS);检测患者入室后、过肝曲及肠镜检查完成时的血浆β-内啡肽含量;记录患者术中疼痛评分(VAS)和镇静评分(VSS),并记录围术期不良反应和满意度。结果:电针组患者分别在结肠镜插镜时和过脾曲时MAP和HR明显低于对照组(P<0.05);与对照组比较,电针组患者肠镜操作过程中BIS明显降低(P<0.01)。两组患者肠镜操作过程中血浆β-内啡肽均明显升高(均P<0.01),过肝曲时电针组患者血浆β-内啡肽低于对照组(P<0.05)。电针组术中咪达唑仑用量明显少于对照组(P<0.05)。术中VAS和VSS,电针组均明显低于对照组(P<0.01);术后电针组与对照组满意度评分比较,电针组明显高于对照组(P<0.05)。结论:电针减轻了肠镜检查时患者的疼痛感,降低了患者的应激水平,能够有效地缓解结肠镜检查引起的各种不良反应。
Objective To observe the effect of electroacupuncture （EA） on bispectral index （BIS） and plasma β-endorphin （β-EP） level in patients undergoing colonoscopy. Methods Sixty patients were equally randomized into EA group and cotrol group with 30 cases in each. EA （2 Hz/100 Hz, 4-6 V） was applied to the right Zusanli （ST 36） and Shangjuxu （ST 37）, and the left Yinlingquan （SP 9）, Sanyinjiao （SP 6） and bilateral Hegu （LI 4） respectively 30 min before colonoscopy. The mean arterial pressure （MAP）, heart rate （HR） and BIS in two groups were continuously monitored during the study. Plasma β-EP concentration was detected by radioimmunoassay. The patient＇s adverse reactions （including pain, satisfaction degree, etc. ） were evaluated by visual analog scale （VAS） and verbal stress scale （VSS）. Results Self-comparison showed that MAP and HR in control group increased significantly during colonoscope＇s splenic flexure passing （P〈0.05）. Whereas the 2 indexes in EA group had no significant changes during colonoscope insertion, and its splenic flexure passing, hepatic flexure passing and post-enteroscopy （P〉0.05）. Comparison between two groups showed that MAP at the time-point of colonoscope insertion, and HR at the time-point of colonoscope＇s splenic flexure passing in EA group were significantly lower than those in control group （P〈0.05）. BIS values of EA group were significantly lower than those of control group at different time-points after colonoscope insertion （P〈0.01）. Plasma β-EP concentrations at the time-points of colonoscope＇s hepatic flexure passing and post-enteroscopy were evidently increased in both groups in comparison with pre-enteroscopy （P〈0.01）, and β-EP was significantly lower in EA group than that in control group at the time-point of colonoscope＇s hepatic flexure passing （P〈0.05）. The dosage of Midazolam used for conscious-sedation and the scores of VAS and VSS were also considerably lower in EA group than those in control group （P〈0.05, P〈0.01 ）. No significant differences were found between two groups in the adverse reactions as dizziness, nausea, vomiting and abdominal pain, but the patients＇ satisfaction degree in EA group was evidently higher than that in control group （P〈0. 05）. Conclusion evel, meaning attenuation Acupuncture analgesia can effectively lower the colonoscopy patients＇ BIS value and plasma β-EP of the patients＇ stress responses during colonoscopy after EA.
出处
《针刺研究》
CAS
CSCD
北大核心
2009年第5期339-343,共5页
Acupuncture Research
基金
浙江省中医药管理局重大项目(2005ZD010)
关键词
肠镜
电针
脑电双频指数
血浆Β内啡肽
Oolonoscopy
Electroacupuncture
Bispectral index
Plasma β-endorphin
