针刺复合硬膜外麻醉对妇科手术患者围手术期IL-1β的影响

目的研究针刺辅助硬膜外麻醉对妇科手术患者围手术期血浆白细胞介素（IL）-1β的影响。方法 40例择期妇科手术患者，随机分为硬膜外麻醉组（简称硬膜外组，20例）和针刺加硬膜外麻醉组（简称针刺加硬膜外组， 20例）。两组患者在实施硬膜外后，针刺加硬膜外组选择足三里、三阴交穴位予以连续电针刺激，频率调至30～100 Hz。观察2组患者围手术期血流动力学变化、术后疼痛视觉模拟评分（VAS）和血浆IL-1β浓度变化。结果 2组患者围手术期血流动力学变化差异无统计学意义（P>0.05）；针刺加硬膜外组患者VAS评分在术后8、 24、48 h低于硬膜外组（P<0.05）；针刺加硬膜外组患者血浆IL-1β浓度在术后4、 24 h及3 d低于硬膜外组（P<0.05）。结论针刺可以降低患者术后的疼痛，降低血浆IL-1β浓度。

英文摘要:

Objective To study the effect of electroacupuncture （EA） combined epidural anesthesia on plasma concentration of IL-1β in patients undergoing gynecological surgery. Methods Forty patients who were scheduled to receive gynecological operation under epidural anesthesia were randomly assigned to the epidural anesthesia group （Group A， 20 cases）and the epidural combined EA group （Group B， 20 cases）. All patients in the two groups recieved epidural anesthesia. Continuous EA at Zusanli （ST36） and Sanyinjiao （SP6） with the frequency of 30－100 Hz was applied in those in Group B. The peri-operative hemodynamic changes， visual analog scale （VAS）， and the plasma concentration of IL-1β were observed. Results There was no statistical difference in peri-operative hemodynamic changes between the two groups （P>0.05）. Compared with Group A， the VAS was lower in Group B at post-operative 8， 24， and 48 h， respectively （P<0.05）， and the plasma concentration of IL-1β was also lower in Group B at post-operative 4 h， 24 h， and 3 days （P<0.05）. Conclusion Acupuncture could ease post-operative pain and reduce the plasma concentration of IL-1β.

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