摘要
目的观察电针预处理对肝门阻断的肝脏切除手术患者术后氧化应激反应和炎症反应的影响。方法 30例择期在Pringle法肝门阻断下行肝脏部分切除手术患者,随机分为电针组和假电针组,每组15例。两组患者均在术前3 d开始每日1次针刺治疗或假针刺治疗,穴位选择双侧日月、气冲、阳陵泉穴,麻醉方法为静吸复合全身麻醉。抽取术前及术后6 h、24 h、48 h、72 h各时间点中心静脉血,检测其氧化应激反应指标超氧化物歧化酶(SOD)、丙二醛(MDA);以及炎症反应指标肿瘤坏死因子(TNF-α)、白介素1、6、10(IL-1、6、10)。结果与假电针组相比,电针组6 h、24 h的SOD活性增高(241±11.4 U/m L,180±12.6 U/m L,P<0.05),而MDA水平降低(11.0±0.8 mmol/L,10.0±0.9 mmol/L,P<0.05);其他观察指标无差异(P>0.05)。结论电针预处理肝门阻断患者可以增加术后早期SOD活性、减低MDA水平,从而减轻部分氧化应激反应,但对全身炎症反应无影响。
Objective To observe the effect of pre-intervention with electroacupuncture on oxidative stress （OS） and inflammatory reaction after hepatectomy under portal occlusion. Method Thirty patients going to receive hepatectomy under Pringle＇s portal occlusion were randomized into an electroacupuncture group and a sham electroacupuncture group, 15 cases each. Three days prior to the surgery, the patients started to receive corresponding acupuncture or sham electroacupuncture treatment by selecting bilateral Riyue （GB24）, Qichong （ST30） and Yanglingquan （GB34）, once a day. The anesthesia method was general （inhalational and intravenous） anesthesia. Central venous blood was drawn before the surgery, and respectively 6 h, 24 h, 48 h and 72 h after the surgery to examine the OS-related parameters, superoxide dismutase （SOD） and malondialdehyde （MDA）, as well as the inflammatory mediators, including tumor necrosis factor-α （TNF-α）, interleukin （IL）-1, IL-6, and IL-10. Result Compared to the sham electroacupuncture group, the SOD activity significantly increased （241 ± 11.4 U/mL, 180 ±12.6 U/mL,P〈0.05） and the MDA level significantly dropped in the electroacupuncture group at 6 h and 24 h after the surgery（11.0 ± 0.8 mmol/L, 10.0 ±0.9 mmol/L,P〈 0.05）; there were no significant between-group differences in the rest indexes （P〉0.05）. Conclusion Pre-intervention with electroacupuncture can up-regulate the activity of SOD and down-regulate the level of MDA in patients after hepatic portal occlusion, and thus partially reduce OS, but it doesn＇t show noticeable effect on inflammatory response.
出处
《上海针灸杂志》
2017年第2期175-179,共5页
Shanghai Journal of Acupuncture and Moxibustion
基金
上海中医药大学预算内项目(2014YSN42)
关键词
针刺
电针
预处理
肝脏缺血再灌注损伤
氧化应激反应
炎症反应
Acupuncture
Electroacupuncture
Pre-intervention
Hepatic ischemia-reperfusion
Oxidative stress
Inflammatory reaction
