经皮穴位电刺激调节肠道微生物群稳态缓解结直肠手术后麻痹性肠梗阻的临床研究OA
Clinical efficacy on transcutaneous acupoint electrical stimulation to regulate intestinal microbiota homeostasis and alleviate paralytic intestinal obstruction after colorectal surgery
目的:探讨经皮穴位电刺激调节肠道微生物群稳态缓解结直肠手术后麻痹性肠梗阻的效果.方法:选取2020年9月-2022年10月保定市第一医院收治的110例麻痹性肠梗阻患者,按照治疗方法将患者分为经皮穴位电刺激组60例,常规治疗组50例.通过16SrRNA测序分析肠道微生物群的相对丰度、α多样性指数及β多样性距离(基于Bray-Curtis距离的PERMANOVA分析).通过临床观察、腹部触诊等方法判断患者的肠道动力学恢复情况,记录患者的肠蠕动频率.通过胃肠功能评估问卷评估两组患者的胃肠道功能及临床症状改善情况.结果:经皮穴位电刺激组肠道乳酸杆菌、双歧杆菌、肠球菌、梭状芽孢杆菌和嗜酸乳杆菌等微生物菌群的相对丰度较常规治疗组增加,肠道菌群Shannon指数和Simpson指数较常规治疗组升高,差异均有统计学意义(P＜0.05),两组间菌群整体结构(β多样性)差异有统计学意义(P＜0.05).经皮穴位电刺激组患者肠蠕动频率较常规治疗组增加,肠道动力恢复时间较常规治疗组缩短,胃肠道功能评分较常规治疗组降低,腹痛、腹胀和恶心呕吐减轻率较常规治疗组升高,排气排便改善率较常规治疗组增加,差异均有统计学意义(P＜0.05).结论:经皮穴位电刺激可能通过调节肠道微生物群稳态促进肠道蠕动,改善胃肠道功能,缓解麻痹性肠梗阻的临床症状.
Objective To investigate the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)in regulating gut microbiota homeostasis to alleviate postoperative paralytic ileus following colorectal surgery.Methods A total of 110 patients with paralytic ileus who underwent colorectal surgery at the First Hospital of Baoding from September 2020 to October 2022 were recruited and divided into the TEAS group(n=60)and the conventional treatment group(n=50)according to the treatment protocol.The relative abundance of gut microbiota,alpha diversity indices,and beta diversity(PERMANOVA test based on Bray-Curtis distance)were analyzed using 16S rRNA sequencing.Intestinal motility recovery was assessed through clinical observation and abdominal palpation,and the frequency of bowel movements within 1 hour was recorded.Gastrointestinal function was compared between the two groups using a gastrointestinal function assessment questionnaire.The improvement in clinical symptoms was also compared between the two groups.Results Compared with the conventional treatment group,the relative abundances of microbial flora such as Lactobacillus,Bifidobacterium,Enterococcus,Clostridium,and Lactobacillus acidophilus in the transcutaneous electrical acupoint stimulation group increased.The Shannon index and Simpson index of the intestinal flora were higher in the transcutaneous electrical acupoint stimulation group than in the conventional treatment group(P＜0.05),and there was a significant difference in the overall structure of the flora(β diversity)between the two groups(P＜0.05).In the transcutaneous electrical acupoint stimulation group,the frequency of intestinal peristalsis increased compared with the conventional treatment group,the recovery time of intestinal motility was shorter,the gastrointestinal function score was lower,the relief rates of abdominal pain,abdominal distension,and nausea and vomiting were higher,and the improvement rate of exhaust and defecation was higher(P＜0.05).Conclusion Percutaneous acupoint electrical stimulation may regulate intestinal microbiota homeostasis,promote intestinal peristalsis,improve gastrointestinal function,and alleviate clinical symptoms of paralytic intestinal obstruction.
张立净;张丽敏;卓杰;许明月
保定市第一医院中医科(河北保定 071000)蠡县医院普外科(河北蠡县 071400)保定市第一医院中医科(河北保定 071000)江苏省人民医院宿迁医院中医科(江苏宿迁 223800)
医药卫生
经皮穴位电刺激生物群稳态结直肠手术麻痹性肠梗阻
Transcutaneous acupoint electrical stimulationbiota homeostasiscolorectal surgeryparalytic intestinal obstruction
《中国中西医结合外科杂志》 2026 (3)
330-334,5
2024年度河北省中医药管理局项目(2024261)保定市科学技术计划项目(2341ZF234)
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