[Transcutaneous electrical acupoint stimulation relieves post-operative nausea and vomiting possibly by reducing serum motilin secretion in patients undergoing laparoscopic surgery].

To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) of different acupoint combinations on postoperative nausea and vomiting (PONV) and serum motilin (MTL) content in patients undergoing laparoscopic surgery, so as to provide evidence for clinical selection of suitable acupoint compatibility.A total of 140 patients undergoing elective laparoscopic surgery were randomly divided into general anesthesia (GA) control, TG2 ［Neiguan (PC6) + Hegu (LI4)］, TG3 ［PC6 + LI4 + Zusanli (ST36)］, and TG4 ［PC6 + LI4 + ST36 + Sanyinjiao (SP6)］ groups, with 35 cases in each group. Patients of the TG2, TG3 and TG4 groups received TEAS (2 Hz/100 Hz, 3-8 mA) of the above mentioned acupoint (bilateral) groups for 30 min before the induction of anesthesia until the end of the operation. Patients of the GA control group received intravenous injection of Midazolam, Sufentanil, Propofol, Rocuronium Bromide, etc. The blood sample (4 mL) from the right median cubital vein was collected at the time of patient's entry, 12 and 24 h after surgery, respectively, for measuring MTL concentration by enzyme-linked immunosorbent assay. The incidence of early and late PONV and changes of PONV degree within 24 h after surgery were recorded.The serum MTL concentrations were significantly decreased at 12 h after surgery in all the 4 groups (P<0.05), and decreased at 24 h after surgery in GA and TG2 groups vs their own pre-surgery (P < 0.05), and considerably higher at both 12 and 24 h after surgery in the TG2, TG3 and TG4 groups than in the GA control group (P<0.05), and also evidently higher in the TG3 and TG4 groups than in the TG2 group (P<0.05). The incidence of PONV was significantly lower in the TG2, TG3 and TG4 groups than in the GA control group in the early and late periods (except TG2 group) of surgery (P<0.05). The number of patients with PONV grade Ⅰ was significantly larger in the TG2, TG3 and TG4 groups than in the GA control group at 24 h after surgery (P<0.05), suggesting a mild PONV in more patients undergoing TEAS.TEAS has a preventive effect on PONV in patients undergoing laparoscopic surgery, which may be related to its effect in reducing serum MTL concentration. The preventive effect of TEAS of PC6 + LI4 + ST36 and PC6 +LI4 + ST36 + SP6 is similar and better than TG2 (two acupoints) group.目的：观察不同穴位配伍的经皮穴位电刺激(TEAS)对腹腔镜手术患者术后恶心呕吐(PONV)及血清胃动素(MTL)分泌的影响，为临床选择合适的穴位配伍提供依据。方法：选取择期行腹腔镜手术患者140例，随机分为TG2组(内关+合谷)、TG3组(内关+合谷+足三里)、TG4组(内关+合谷+足三里+三阴交)和G组(常规全麻组)，每组35例。TG2组、TG3组、TG4组于麻醉诱导前30 min经皮电刺激相应的双侧穴位至术毕。G组为常规全麻组，未给予TEAS。分别于患者入室时、术后12 h和术后24 h时，用酶联免疫吸附法测定患者血清MTL含量；记录患者术后早期PONV、晚期PONV发生率及患者术后24 h内PONV分级情况。结果：与术前比较，各组患者术后12 h的血清MTL含量均下降（P<0.05），G组、TG2组术后24 h的血清MTL含量下降(P<0.05)；与G组比较，TG2组、TG3组及TG4组术后12 h、24 h时的血清MTL含量升高(P<0.05)，术后早期PONV发生率降低(P<0.05)；TG3组、TG4组术后晚期PONV发生率降低(P<0.05)，术后24 h内PONV分级降低(P<0.05)；与TG2组比较，TG3组、TG4组术后12 h、24 h时的血清MTL含量升高(P<0.05)。结论：TEAS对腹腔镜手术患者的PONV有预防效果，其机制可能与减少MTL含量下降的幅度有关。其中内关+合谷+足三里与内关+合谷+足三里+三阴交在减缓PONV方面效果相近且最佳。.