Objective: To observe the effect of electroacupuncture combined with enhanced recovery after surgery (ERAS) protocol on promoting intestinal function in patients after gastric cancer surgery.
Methods: Forty-four patients who underwent radical gastrectomy for gastric cancer were randomly divided into an experimental group (22 cases, 3 cases were excluded) and a control group (22 cases, 4 cases were excluded). Both groups received treatment under ERAS protocol, the experimental group was given electroacupuncture at bilateral Neiguan (PC6), Hegu (LI4), Zusanli (ST36) and Quchi (LI11), disperse-dense wave was selected, with frequency of 2 Hz/100 Hz. The control group received placebo electroacupuncture intervention, with the same acupoints as the experimental group, electrode pads were placed on the acupoints without electrical stimulation. Each session lasted 30 min, starting from 1 h after surgery, once every 24 h, until the patient resumed anal flatus. The intestinal sound rate of both groups was observed 24 h before surgery and 24, 48 h after surgery. The bowel sound recovery time (BSRT), time to first anal flatus, time to first defecation, and tolerance to oral enteral nutrition suspension were compared between the two groups. The levels of serum C-reactive protein (CRP), interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, IL-17, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured 24 h before surgery and 24 h after surgery in both groups.
Results: The intestinal sound rate 24 h after surgery was decreased compared with that 24 h before surgery in the two groups (P<0.05), the intestinal sound rate 24, 48 h after surgery in the experimental group was higher than that in the control group (P<0.05). The BSRT in the experimental group was earlier than that in the control group (P<0.05) .The levels of serum CRP, IL-6, IL-10 24 h after surgery in the experimental group were higher than those 24 h before surgery (P<0.05), while the levels of serum CRP, IL-4, IL-6, IL-10, IFN-γ in the control group were higher than those 24 h before surgery (P<0.05); the levels of serum CRP、IL-4、IFN-γ 24 h after surgery in the experimental group were lower than those in the control group (P<0.05) .The tolerance rate of oral enteral nutrition suspension in the experimental group was 84.2% (16/19), which was higher than 50.0% (9/18) in the control group (P<0.05).
Conclusion: Electroacupuncture combined with ERAS protocol can improve the intestinal motility, shorten the BSRT, enhance the tolerance of oral intake, and reduce inflammatory response in patients after gastric cancer surgery.
目的：观察电针联合加速康复外科（ERAS）方案促进胃癌术后患者肠功能恢复的效果。 方法：将44例行胃癌根治术的患者随机分为试验组（22例，剔除3例）和对照组（22例，剔除4例）。两组患者均接受ERAS方案治疗，试验组予电针治疗，穴取双侧内关、合谷、足三里、曲池，疏密波，频率为2 Hz/100 Hz；对照组予安慰电针干预，取穴与试验组一致，将穴位贴敷电极片贴敷于穴位上，不予电刺激。每次30 min，术后1 h开始治疗，间隔24 h 1次，直至患者恢复肛门排气。观察两组患者术前24 h及术后24、48 h肠率，比较两组患者肠鸣音恢复时间（BSRT）、肛门首次排气及排便时间、口服肠内营养混悬液耐受情况，比较两组患者术前24 h及术后24 h血清C反应蛋白（CRP）、白细胞介素（IL）-2、IL-4、IL-6、IL-10、IL-12、IL-17、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）含量。 结果：两组患者术后24 h肠率均较术前24 h降低（P<0.05）；试验组术后24、48 h肠率高于对照组（P<0.05）。试验组BSRT早于对照组（P<0.05）。术后24 h，试验组血清CRP、IL-6、IL-10含量高于术前24 h（P<0.05），对照组血清CRP、IL-4、IL-6、IL-10、IFN-γ含量高于术前24 h（P<0.05）；试验组血清CRP、IL-4、IFN-γ含量低于对照组（P<0.05）。试验组口服肠内营养混悬液的耐受良好率为84.2%（16/19），优于对照组的50.0%（9/18，P<0.05）。 结论：电针联合ERAS方案能够提高胃癌术后患者肠率水平，缩短BSRT，改善经口进食的耐受情况，降低炎性反应。.
Keywords: electroacupuncture; enhanced recovery after surgery; intestinal function; placebo electroacupuncture; post-gastric cancer surgery; randomized controlled trial (RCT).