针刺镇痛和对抗手术中生理扰乱的调整作用

已被国内外针麻临床和实验研究所确认.但针刺效应可持续多久?尤其是针刺的后效应对机体康复起多大作用?没有引起应有的注意。深入研究针刺的后效应

将有助于全面地认识针刺对机体的作用和针刺的基本原理的阐明。本文选择溃疡病胃大部切除术患者103例

观察术后康复过程中创伤性“手术热”的程度与持续时间、血液白细胞变化、术后伤口痛时腹直肌肌电图的变化和肠蠕动功能恢复时间等指标

了解到针刺的后效应主要表现为抗手术创伤和促进机体康复两方面的作用

现将研究结果报告如下:The analgesic effect of acupuncture and its adjusting effect on physio- logical disturbances of the surgery have been proved at home and abroad by clinical and experimental research. This paper reports 103 selected cases of partial gastrectomy in peptic ulcer patients

comparing the data of phyological and biochemical changes during the postoperative recovery;the study of post-acupuncture effects in cases having undergone acupuncture anesthesia

epidural anesthesia and general anesthesia

resulted in the following findinds: A.The post-acupuncture effects on“post-operative fever”. The average rise in temperature caused by surgical trauma(“post-opera- tire fever”)usually does not exceed 38.2℃.In observing continually for a week after operation

the“postoperative fever”of the acupuncture group is lowr than that of other groups.The average duration of“post-operative fever”of the acupuncture anesthesia group is 3.45 days

of the epidural anesthesia group

4.91 days

and of the general anesthesia group

6.9 days. The difference is very significant.(P<0.001). The post-operative change of the pulse rate in the acupuncture anesthesia group was less than that in other groups

with a marked difference on the first day after operation compared with the epidural anesthesia group(P< 0.05).This may indicate that the resistance of the body against surgical trauma has been increased after acupuncture. B.Post-acupunture effect on against infection: In comparing the total white cell and neutrocyte count on the second day after surgery with those before it

both of these counts were increased in all three groups;however the increase in the acupuncture anesthesia group was most significant(P<0.01).The total white cell count increased 70、2%

the neutroeytes increased 23.4%.As professor Гордиенко pointed out

the increase in wbc is proportional to the ability of phagocytosis According to a report from Beijing

acupuncture on Zusanli point will increase the ability of phagocytosis lasting for 72 hours.This statement is in coincidence with our experience

indicating the existance of a post- operative antiinflammatory effect. C.The postoperative analgesic effect on the incisional wound: The electro-myogram of the rectus muscle was observed continually for 3 hrs after operation.The average accumulated voltage of electromyo- dium in acupuncture anesthesia and epidural anesthesia were 14.2 μV and 13.7μV.respectively

the difference being insignificant.However

it was found that during the first 1.5 hrs.the microvoltage in acupuncture anes- thesia cases was higher than that of the epidural anesthesia cases

while in the later 1.5 hrs.in acupuncture anesthesia

it was lower than that in the epidural anesthesia.This shows that the efficacy of acupuncture anls- thesia was not so good as that of the epidural anesthesia.But after removal of theneedles

the analgesic effect against postoperative incisional pain did persist to a certain extent. D.The post-acupuncture effect on recovery. In observing the duration needed for the first flatus expulsion after operation

the average duration in the acupuncture anesthesia group was 44.15 hrs

and in the epidural anesthesia group 56.12 hrs.This shows that aeupuncuure can mitigate physiological disturbance of the intestinal func- tion

and be beneficial to recovery.