Effects of transcutaneous electrical acupoint stimulation on quality of recovery during early period after laparoscopic cholecystectomy / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the quality of recovery during the early period after laparoscopic cholecystectomy and the dosage of anesthetic and analgesic.</p><p><b>METHODS</b>One hundred patients who received laparoscopic cholecystectomy with gradeⅠand Ⅱ of American Society of Anesthesiologists (ASA) criteria were randomly assigned into an observation group and a control group according to random number table, 50 cases in each group. The patients in the two groups were treated with conventional endotracheal intubation anesthesia, anesthesia induction and maintenance. The patients in the observation group were treated with TEAS (2 Hz/100 Hz, 8 to 12 mA) at bilateral Hegu (LI 4) and Neiguan (PC 6), as well as Zusanli (ST 36) and the non-acupoint 2 outboard from Zusanli (ST 36) from 30 min before anesthesia induction to the end of operation. The patients in the control group were applied by stimulation electrode in the corresponding points without electrical stimulation. The dosage of intraoperative remifentanil and the analgesic dosage of dezocine for postoperation were recorded. The recovery time, extubation time, the changes of heart rate (HR) and mean arterial pressure (MAP) during extubation were recorded. The quality of recovery was assessed by the quality of recovery-40 questionnaire (QoR-40) 1 day before surgery (T)，and 4 h (T), 8 h (T), 24 h (T), 48 h (T) after surgery. The patient's cognitive function was assessed by mini-mental state examination (MMSE) scale at the 5 time points. The incidences of postoperative nausea and vomiting were recorded at T through T.</p><p><b>RESULTS</b>The dosages of intraoperative remifentanil and dezocine in the observation group were less than those in the control group; the recovery time and extubation time were shorter than those in the control group; the HR of extubation was lower than that in the control group (all <0.05). There was no statistic difference about MAP between the two groups (>0.05). Compared with T, the total scores of QoR-40 decreased in the two groups at T, T, T (all <0.05), and the total scores in the observation group were higher than those in the control group (all <0.05). The emotional state, physical comfort, psychological support, self-care ability, pain scores at T in the observation group and at T, T, T in the control group were lower than those at T (all <0.05). The emotional state, physical comfort, psychological support, self-care ability, pain scores in the observation group were higher than those in the control group at T, T, T (all <0.05). Compared with T, the MMSE scores in the two groups decreased at T and T (all <0.05). At T, T, T, the MMSE scores in the observation group were higher than those in the control group (all <0.05). At T and T, the incidence rates of nausea and vomiting were 22.0% (11/50), 12.0% (6/50) respectively in the observation group, which were lower than 32.0% (16/50) and 24.0% (12/50) in the control group (both <0.05). At T and T, the incidence rates of nausea and vomiting were 6.0% (3/50), 2.0% (1/50) respectively in the observation group, which were not significantly different from 8.0% (4/50) and 4.0% (2/50) in the control group (both >0.05).</p><p><b>CONCLUSION</b>TEAS can improve the quality of recovery during the early period after laparoscopic cholecystectomy and reduce the dosage of anesthetic and analgesic.</p>

Effects of different moxibustion temperature on cholesterol and skin around "Shenque" (CV 8) in mice with hyperlipidemia / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of moxibustion with different temperatures on cholesterol and skin around "Shenque" (CV 8) in mice with acute hyperlipidemia, and to explore the correlation between moxibustion effect and transient receptor potential vanilloid 1 (TRPV1).</p><p><b>METHODS</b>Eight mice among 32 mice of C57BL/6J wild type (WT) were selected into a blank group, and the remaining 24 mice were made into the acute hyperlipidemia model by injection of egg yolk. After model establishment, the mice were randomly divided into a model group, a 38 °C moxibustion group and a 46 °C moxibustion group, 8 mice in each group. The temperature was (38 ± 1) °C in the 38 °C moxibustion group and (46 ± 1) °C in the 46 °C moxibustion group. "Shenque" (CV 8) and "Zusanli" (ST 36) were selected in the two groups; moxibustion was given for 10 min per time, once a day for 2 times. Mice in the blank group and model group were treated with immobilization and moxibustion was not given. After treatment, the level of serum cholesterol was tested by oxidase method; the morphology of skin around "Shenque" (CV 8) was observed by HE staining; the expression of TRPV1 in skin was measured by immunohistochemistry.</p><p><b>RESULTS</b>(1) Compared with the blank group, the level of serum cholesterol was increased in the model group (P < 0.001); compared with the model group, the level of serum cholesterol was reduced in the 46 °C moxibustion group (P < 0.001); compared with the 38 °C moxibustion group, the level of serum cholesterol was reduced in the 46 °C moxibustion group (P < 0.01). (2) There was slight change of morphology and structure in skin tissue in the 38 °C moxibustion group, while obvious change was observed in the 46 °C moxibustion group, indicating specific change. (3) The difference of the expression of TRPV1 in skin was significantly different between 46 °C moxibustion group and blank group, model group (both P < 0.01); it was also different from the 38 °C moxibustion group (P < 0.05).</p><p><b>CONCLUSION</b>Moxibustion temperature is one of the important factors affecting the cholesterol and acupoint skin. The effects of moxibustion are related to TRPV1.</p>

Effect of abdominal breathing combined with application of acupoint massage on relieving laparoscopic abdominal distention / 现代临床护理

Objective To investigate the effect of abdominal breathing combined with acupoint massage to relieve abdominal distention after laparoscopic surgery.Methods One hundred and eighty patients with abdominal distention after laparoscopic surgery were randomly divided into control group and observation group with 90 patients in each group. The control group was given conventional perioperative nursing and the observation group combined with acupoint massage including Zusanli, Shangjuxu,Xiajuxu,and Neiguanxue based on the use of abdominal breathing to relieve postoperative abdominal distension. Result The abdominal distension of the observation group was significantly lower than that in the control group,the recovery time of intestinal peristalsis and anus exhaust time were significantly shorter than those of the control group after 3 d(all P<0.01).Conclusion Abdominal breathing combined with acupoint massage can relieve abdominal distension of patients after laparoscopic surgery and promote intestinal function recovery.