|
|
|
| Effect of acupuncture combined with general anesthesia on cognitive function and related inflammatory factors in elderly patients with tumor resection |
| LIU Zhi TENG Yongjie |
| Department of Anesthesiology, the First Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine, Hu′nan Province, Changsha 410007, China |
|
|
|
Abstract Objective To investigate the effect of acupuncture combined with general anesthesia on cognitive function and related inflammatory factors in elderly patients underwent tumor resection. Methods A total of 98 elderly patients underwent tumor resection in the First Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine from June 2015 to December 2016 were enrolled. The patients were divided into two groups according to the random number table method, each group had 49 cases. Patients in the control group were treated with general anesthesia. Patients in the observation group were treated with acupuncture combined with general anesthesia. All patients were scored by mini-mental state examination (MMSE) at 1 day before operation, 1 day after operation and 3 days after operation. The incidence of postoperative cognitive dysfunction (POCD) was calculated. The levels of serum TNF-α, IL-1β and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) before operation, at operation completed, 24 h and 48 h after operation. Results The MMSE scores of the observation group were significantly higher than those of the control group at 1 day and 3 days after operation, the incidence rates of POCD were lower than those of the control group, the differences were statistically significant (P < 0.05). The levels of TNF-α, IL-1β and IL-6 in the two groups at operation completed, 24 h and 48 h after operation were significantly higher than those before operation, and the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). Conclusion Acupuncture combined with general anesthesia can reduce the incidence of POCD in elderly patients underwent tumor resection. The mechanism may be related to the decrease of the levels of serum TNF-α, IL-1β and IL-6 in patients.
|
|
|
|
|
|
[1] 左蕾，李琪英，刘丹彦.麻醉与术后认知功能障碍相关机制的研究进展[J].医学综述，2013，19（10）：1847-1849.
[2] Feinkohl I，Winterer G，Spies CD，et al. Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction [J]. Dtsch Arztebl Int，2017，114（7）：110-117.
[3] 刘杨，熊利泽.针药平衡麻醉及其临床研究进展[J].临床麻醉学杂志，2016，32（5）：507-509.
[4] Goettel N，Burkhart CS，Rossi A，et al. Associations Between Impaired Cerebral Blood Flow Autoregulation， Cerebral Oxygenation， and Biomarkers of Brain Injury and Postoperative Cognitive Dysfunction in Elderly Patients After Major Noncardiac Surgery [J]. Anesth Analg，2017，124（3）：934-942.
[5] 余德华.老年术后认知功能障碍及右美托咪啶在其治疗中的作用[J].中国医药导报，2015，12（6）：164-168.
[6] Kline R，Wong E，Haile M，et al. Peri-Operative Inflammatory Cytokines in Plasma of the Elderly Correlate in Prospective Study with Postoperative Changes in Cognitive Test Scores [J]. Int J Anesthesiol Res，2016，4（8）：313-321.
[7] 沙粒，孔宪诚，谢晓峰，等.针药复合麻醉对于腹腔镜胆囊切除术患者脏器功能的影响[J].上海针灸杂志，2015， 34（10）：938-940.
[8] 林舜艳，尹正录，高巨，等.针药复合麻醉对老年患者术后早期认知功能障碍及炎性细胞因子TNF-α、IL-1β、IL-6的影响[J].中国中西医结合杂志，2014，34（7）：795-799.
[9] 肖义荣，曾凯，林财珠.不同麻醉药对老年肺癌患者术后认知功能的影响[J].实用癌症杂志，2014，29（8）：933-935，938.
[10] Wang W，Zhang XY，Feng ZG，et al. Overexpression of phosphodiesterase-4 subtypes involved in surgery-induced neuroinflammation and cognitive dysfunction in mice [J]. Brain Res Bull，2017，21（130）：274-282.
[11] 薄海艳，徐忠敏.耳针配合百会穴针刺治疗紧张性头痛的临床观察[J].内蒙古中医药，2011，30（16）：50-51.
[12] 石立业，尚清，马彩云.内关穴针刺治疗痉挛性脑瘫患儿精细运动障碍临床研究[J].中医临床研究，2016，8（5）：4-6.
[13] 陈素辉，孙华，徐虹，等.针刺百会和足三里穴对脑缺血再灌注损伤大鼠双侧脑组织白细胞介素-6表达的影响[J].针灸临床杂志，2014，30（1）：42-45，73.
[14] 陈玲，张清华，蒋知新，等.炎症因子对人脐静脉内皮细胞表达血管内皮生长因子及妊娠相关血浆蛋白-A的影响[J].广东医学，2009，30（2）：193-195.
[15] 孙幸，沈连军，顾蔚，等.炎症因子在非肿瘤下肢深静脉血栓形成中的作用[J].中华医学杂志，2015，95（8）：598-600.
[16] 郭飞，张俊杰，孙俊锋，等.肾母细胞瘤瘤体中差异性炎症因子的鉴定及其临床意义[J].中华泌尿外科杂志，2016， 37（3）：214-218.
[17] 赵鹏.炎症因子TNF-α上调TROP-2表达在结肠癌细胞侵袭迁移中的作用和意义[D].石家庄：河北医科大学，2015.
[18] 陈欣，宋岩.针刺配合中药塌渍法对多囊卵巢综合征血清炎症因子的影响[J].吉林中医药，2016，36（6）：616-618.
[19] Zheng JW，Meng B，Li XY，et al. NF-κB/P65 signaling pathway：a potential therapeutic target in postoperative cognitive dysfunction after sevoflurane anesthesia [J]. Eur Rev Med Pharmacol Sci，2017，21（2）：394-407.
[20] 袁军，吴昱，李继勇，等.右美托咪定复合电针刺激对脑外介入治疗患者术后认知功能的影响[J].中国中西医结合杂志，2016，36（3）：285-288. |
|
|
|
