Acupuncture, as a healing art in traditional Chinese medicine, has been widely used to treat various diseases. In the history of acupuncture anesthesia, in the past decades, mechanisms of acupuncture analgesia has been widely investigated, and in recent years, acupuncture protection on organ functions has attracted great interest. This review summarized the research progress on mechanisms of acupuncture for analgesia and its protection against organ function injury in anesthesia, and its perspective of analgesia, immunomodulation, neuroendocrine regulation and multiple organ protection. The current evidence supports that acupuncture analgesia and its organ protection in anesthesia is associated with the integration of neuroendocrine-immune networks in the level of neurotransmitters, cytokines, hormones, neuronal ensembles,lymphocytes, and endocrine cells. Although the mechanisms of acupuncture analgesia and its organ protection are still not completely understood, basic as well as clinic researches on the mechanisms and applications of acupuncture and related techniques are being carried out.
目的探讨经皮穴位电刺激(TAES)对老年患者腹腔镜直肠癌切除术后认知功能的影响及其可能的机制。方法选择2011年6月—2014年5月温州医科大学附属第一医院肿瘤外科收治的腹腔镜下直肠癌Dixon手术的老年患者60例,采用随机数字表法分为对照组30例和TAES组30例。两组患者均选择全凭静脉麻醉,TAES组患者麻醉诱导前30 min至术毕加用TAES进行干预。在围术期使用精神状态简易速检表(MMSE)对患者认知功能进行评分,并在不同时间点检测患者血清超氧化物歧化酶(SOD)、丙二醛(MDA)、S100β水平。结果 MMSE评分治疗方法与时间无交互作用(P>0.05);组间比较,差异有统计学意义(P<0.05);时间间比较,差异有统计学意义(P<0.05)。术后1、3、5 d TAES组MMSE评分高于对照组(P<0.05)。术后1、3 d TAES组患者POCD严重程度低于对照组(P<0.05),术后5、7 d两组患者POCD严重程度比较,差异无统计学意义(P>0.05)。SOD、MDA、S100β水平治疗方法与时间无交互作用(P>0.05);组间比较,差异有统计学意义(P<0.05);时间间比较,差异有统计学意义(P<0.05)。术毕,术后2、6、24 h TAES组SOD水平高于对照组(P<0.05);术后2、6、24 h TAES组MDA、S100β水平低于对照组(P<0.05)。结论老年患者腹腔镜直肠癌切除导致术后认知功能障碍,TAES通过增加SOD水平、抑制MDA聚集、减少S100β释放,保护脑功能,可以明显减少患者术后认知功能障碍的发生。
