陈虎林,刘杰,吴德卫,韦瑞玲,董娟,余跃
CHEN Hulin,LIU Jie,WU Dewei,WEI Ruiling,DONG Juan,YU Yue

• 1:合肥市第八人民医院肛肠科
• 2:安徽省立医院消化科

摘要(Abstract)：

目的：探讨经皮穴位电刺激（TEAS）治疗胃癌术后胃食管反流的疗效及对患者血清胃动素（MTL）、血管活性肠肽（VIP）水平的影响。方法：将86例胃癌术后胃食管反流患者随机分为观察组和对照组各43例。观察组采用TEAS进行治疗，取穴同侧足三里、内关，每周治疗7次，每次20 min；对照组口服雷贝拉唑钠肠溶胶囊治疗，日2次。两组疗程均为6周。比较两组患者治疗前后胃食管反流症状评分、食管动力学指标（食管下括约肌压力、肌长度及食管收缩幅度、食管蠕动波传导速度），以及血清MTL、VIP水平，评价疗效。结果：治疗后，两组患者胃食管反流各项症状评分均下降（P<0.05），且观察组低于对照组（P<0.05）。治疗后两组患者食管收缩幅度、食管蠕动波传导速度均增加（P<0.05），且观察组增幅更明显（P<0.05）；治疗前后两组患者食管下括约肌长度、肌压力变化差异无统计学意义（P>0.05）。治疗后两组患者血清VIP水平均下降，MTL水平均增加（P<0.05），组间比较，差异均有统计学意义（P<0.05）。治疗后观察组总有效率86.05%，对照组72.09%，观察组疗效优于对照组（P<0.05）。结论：TEAS通过提高食管收缩幅度及蠕动波传导速度改善胃癌患者术后胃食管反流症状，其机制可能与调控血清MTL、VIP水平有关。
Objective:To study the curative efficacy of transcutaneous electrical acupoint stimulation(TEAS)on gastroesophageal reflux in patients with gastric cancer after operation,and the influence on serum motilin(MTL) and vasoactive intestinal peptide( VIP).Methods:Eighty six patients with gastroesophageal reflux symptoms after gastric cancer operation were randomly divided into observation group and control group,43 patients in each group. The observation group was treated with TEAS on Zusanli(ST 36) and Neiguan(PC 6) ipsilaterally,7 times a week,20 minutes each time. The control group was given oral administration of rabeprazole sodium enteric coated capsules,2 times a day. Both groups were treated for 6weeks. Before and after treatment,the scores of gastroesophageal reflux symptoms,esophageal sphincter kinetics index(lower esophageal sphincter pressure,muscle length and esophageal contraction amplitude,esophageal velocity of peristaltic wave),serum levels of MTL and VIP were compared. And evaluate the efficacy. Results:After the treatment,the scores of each gastroesophageal reflux symptom in the two groups were decreased(P<0.05),and the decrease in the observation was more obvious(P <0.05). The esophageal contraction amplitude and the esophageal velocity of peristaltic wave were increased in the two groups(P<0.05),and the increase was more obvious in the observation group(P<0.05). The length of lower esophageal sphincter and muscle pressure in the two groups showed no changes(P>0.05). Serum level of VIP decreased and serum level of MTL increased in both groups(P<0.05),the differences between both groups were statistically significant(P<0.05). The effectiveness rate in the observation group was 86.05%,and in the control group was 72.09%,indicating that the efficacy in the observation group was better than that in the control group(P<0.05). Conclusion:TEAS can improve the symptoms of gastroesophageal reflux in postoperative patients with gastric cancer by increasing the amplitude of contraction and peristaltic wave velocity in esophagus,and the mechanism might be regulating serum levels of MTL and VIP.

关键词(KeyWords)： 经皮穴位电刺激;胃癌术后;胃食管反流;胃动素;血管活性肠肽
transcutaneous electrical acupoint stimulation;after gastric cancer operation;gastroesophageal reflux;motilin;vasoactive intestinal peptide

Abstract:

Keywords:

基金项目(Foundation): 安徽省对外科技合作计划项目（编号：1604b0602021）

作者(Author): 陈虎林,刘杰,吴德卫,韦瑞玲,董娟,余跃
CHEN Hulin,LIU Jie,WU Dewei,WEI Ruiling,DONG Juan,YU Yue

DOI: 10.16295/j.cnki.0257-358x.2022.11.010

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