经皮穴位电刺激改善接受视频辅助胸腔镜手术的老年患者的术后认知功能:一项随机对照试验

魏华; 黄俊生; 赵芳; 解志强; 夏之阳; 甘建辉

doi:10.1007/s11655-022-3516-1

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经皮穴位电刺激改善接受视频辅助胸腔镜手术的老年患者的术后认知功能:一项随机对照试验

Acupuncture Research | Updated：2022-07-20

- 经皮穴位电刺激改善接受视频辅助胸腔镜手术的老年患者的术后认知功能:一项随机对照试验
- Transcutaneous Electrical Acupoint Stimulation Improves Postoperative Cognitive Function in Senior Patients Undergoing Video-Assisted Thoracoscopic Surgery:A Randomized Controlled Trial
- Chinese Journal of Integrative Medicine 2022年28卷第8期页码：730-735
- Affiliations：
  
  1.Department of Anesthesiology, Tangshan People's Hospital,Tangshan Hebei Province (063000), China
  2.Department of Anesthesiology, Tangshan Central Hospital, Tangshan, Hebei Province (063000), China
- Author bio：
  
  Prof. GAN Jian-hui, E-mail:Jianhuigan2021@163.com
- Funds：
  
  Hebei Provincial Health Commission Research Project of China(20211487)
- DOI：10.1007/s11655-022-3516-1
  中图分类号：
- 纸质出版日期：2022-08，
  
  网络出版日期：2022-05-11，
  
  录用日期：2021-08-04
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魏华, 黄俊生, 赵芳, 等. 经皮穴位电刺激改善接受视频辅助胸腔镜手术的老年患者的术后认知功能:一项随机对照试验[J]. Chinese Journal of Integrative Medicine, 2022,28(8):730-735.

Hua WEI, Jun-sheng HUANG, Fang ZHAO, et al. Transcutaneous Electrical Acupoint Stimulation Improves Postoperative Cognitive Function in Senior Patients Undergoing Video-Assisted Thoracoscopic Surgery:A Randomized Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(8):730-735.
魏华, 黄俊生, 赵芳, 等. 经皮穴位电刺激改善接受视频辅助胸腔镜手术的老年患者的术后认知功能:一项随机对照试验[J]. Chinese Journal of Integrative Medicine, 2022,28(8):730-735. DOI： 10.1007/s11655-022-3516-1.

Hua WEI, Jun-sheng HUANG, Fang ZHAO, et al. Transcutaneous Electrical Acupoint Stimulation Improves Postoperative Cognitive Function in Senior Patients Undergoing Video-Assisted Thoracoscopic Surgery:A Randomized Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(8):730-735. DOI： 10.1007/s11655-022-3516-1.

摘要

目的:

评价经皮穴位刺激 (TEAS) 对改善接受视频辅助胸腔镜手术 (VATS) 的老年患者术后认知功能的有效性和安全性.

方法:

从2020年1月至12月

97名参与者通过随机数字表被随机分配到TEAS组 (49例) 和对照组 (48例) . TEAS组的患者接受TEAS

在双侧内关 (PC 6) 和足三里 (ST 36) 穴位. 对照组接受假的TEAS. 刺激从手术前30分钟开始

直到手术结束. 主要结果是术后认知功能障碍 (POCD) 的发生率

根据小型精神状态检查 (MMSE) 和蒙特利尔认知评估 (MoCA) 分数的变化进行诊断. 次要结果是血浆中S100β蛋白和神经元特异性烯醇化酶 (NSE) 的水平.

结果:

TEAS组术后第1天和第3天的POCD发生率明显低于对照组[术后第1天: 28.3% (13/46) vs. 52.3% (23/44)

=0.028; 术后第3天: 21.7% (10/46) vs. 40.9% (18/44)

=0.043] . 与基线相比

两组的MMSE和MoCA得分都有不同程度的下降. TEAS组术后第1、3、5天MMSE评分及术后第1、3、5、7天MoCA评分均高于对照组(均

0.05 ). 与基线比较

术后4、8、12、24 h血浆S100β、NSE水平明显升高(均

0.05 ). 与对照组比较

TEAS组在术后4、8、12、24 h血浆S100β、NSE水平均较低(均

0.05 ). 试验期间未发现明显不良事件.

结论:

VATS术后老年患者应用TEAS可降低POCD发生率

改善术后认知功能.

Abstract

Objective:

To evaluate the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) for improving postoperative cognitive function in senior patients undergoing video-assisted thoracoscopic surgical (VATS).

Methods:

From January to December 2020

97 participants were randomly assigned to the TEAS group (49 cases) and the control group (48 cases) by a random number table. The patients in the TEAS group received TEAS

at the bilateral Neiguan (PC 6) and Zusanli (ST 36) acupoints. The control group received sham TEAS. The stimulation was started from 30 min before surgery until the end of the operation. The primary outcome was the incidence of pstoperative cognitive dysfunction (POCD)

diagnosed based on the changes in the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. The secondary outcomes were plasma levels of S100β protein and neuron-specific enolase (NSE).

Results:

The incidence of POCD on day 1 and 3 after surgery in the TEAS group was significantly lower than that in the control group [day 1 after surgery: 28.3% (13/46) vs. 52.3% (23/44)

=0.028; day 3 after surgery: 21.7% (10/46) vs. 40.9% (18/44)

=0.043]. Compared with baseline

the MMSE and MoCA scores decreased to various extents in both groups. The MMSE scores on day 1

and 5 after surgery and MoCA scores on day 1

and 7 after surgery in the TEAS group were higher than those in the control group (all

0.05) in both groups. Compared with baseline

the plasma levels of S100β and NSE were significantly increased at 4

24 h after surgery (all

0.05). Compared with the control group

the plasma levels of S100β and NSE were lower in the TEAS group at 4

and 24 h after surgery (all

0.05). No obvious adverse events were found during the trial.

Conclusion:

Application of TEAS in senior patients after VATS could reduce incidence of POCD and improve postoperative cognitive function.

关键词

经皮穴位电刺激电视胸腔镜手术高龄术后认知功能障碍

Keywords

transcutaneous electrical acupoint stimulationvideo-assisted thoracic surgeryseniorpostoperative cognitive dysfunction

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