电针对急性胰腺炎患者胃肠动力的影响及其机制研究

目的:探讨电针在治疗急性胰腺炎胃肠动力紊乱中的作用及作用机理。方法:94例急性胰腺炎患者,分为电针治疗组56例和对照组38例。两组在予以抗感染、抑制胰腺分泌、改善微循环、胃黏膜保护剂同时,电针治疗组选取双侧足三里、上巨虚、悬钟、公孙、太冲,KWD-808Ⅰ多功能电针治疗仪电针治疗,每次60 min,每日2次,共5 d。选用Metealf改良简化技术,应用不透X线的标志物(SITZMARKS)测定急性胰腺炎患者全结肠及各节段的结肠转运时间(CTT)。放射免疫法测定血清中胃动素(motilin,MTL)、胆囊收缩素(cholecystokinin,CCK)和血管活性肠肽(vasoactive intestinal peptide,VIP)的浓度变化。结果:56例电针治疗患者的全结肠及各结肠节段的CTT比对照组38例患者明显缩短(P<0.05)。两组患者治疗后的MTL、CCK较治疗前升高,VIP水平下降(P<0.05),但两组之间比较差异均不显著(P>0.05)。结论:电针能显著提高急性胰腺炎患者的胃肠动力,其改善急性胰腺炎胃肠动力紊乱的机制是否与对胃肠激素的调节有关尚不明确。

Effect of Electroacupuncture on Gastrointestinal Dynamics in Acute Pancreatitis Patients and Its Mechanism

OBJECTIVE: To investigate the therapeutic effect and mechanism of electroacupuncture (EA) in treating gastrointestinal disorder in acute pancreatitis (AP) patients. METHODS: A total of 94 cases of AP patients were divided into acupuncture group (n=56) and control group (n=38). The severity of AP was evaluated according to APACHE II and Balthazar CT scoring system. EA (4 Hz, 4-6 V) was applied to bilateral Zusanli (ST 36), Shangjuxu (ST 37), Xuanzhong (GB 39), Taichong (LR 3), and Gongsun (SP 4) for 60 min, twice a day, 5 days altogether. Total and segmental colonic transit time (CTT) were determined by using ingestion of radiopaque markers (SITZMARKS) according to the modified Metcalf's method, serum motilin (MTL), cholecystokinin (CCK), vasoactive intestinal peptide (VIP) contents were assayed using enzyme linked immunosorbent assay (ELISA). RESULTS: Compared with normal values, total and segmental CTT of AP patients (control group) increased apparently (P < 0.05), especially in right colon, serum MTL and CCK contents in both control and treatment groups on the 1st day decreased considerably (P < 0.05), while serum VIP levels of both control and treatment groups on the 1st day increased markedly (P < 0.05). In comparison with control group, total and segmental CTT of treatment group decreased significantly (P < 0.05). Auto-comparison of both control and treatment groups showed that serum MTL and CCK contents on day 9 were significantly higher than those on day 1 (P < 0.05), while serum VIP contents on day 9 in these two groups were both obviously lower than those on day 1 (P < 0.05). No significant differences were found between treatment group and control group in serum MTL, CCK and VIP levels on the 9th day after the treatment (P > 0.05). CONCLUSION: Acupuncture is able to enhance the gastrointestinal dynamics, improve its motor activity.