Effect Of Transcutaneous Electrical Acupoint Stimulation On The Incidence Of Systemic Inflammatory Response Syndrome In Patients Undergoing Radical Surgery For Gastric Cancer

Severe trauma, burn, major operation etc, can lead to the occurrences of SIRS, Sepsis, MODS, and even death. At present, it is believed that the potential mechanism of SIRS is related to the over release of pro-inflammatory mediators, the imbalance between pro-inflammatory and anti-inflammatory mediators and the dysfunction of the immune system. Therefore, modulation of the inflammatory reaction and maintaining the immune balance are important methods to control sepsis and MODS. Acupuncture exerts the immune regulation effects by regulating the immune cells, immune globulin and cytokines. In addition, the cholinergic anti-inflammatory pathway, Toll like receptors / nuclear factor kappa B pathway, hypothalamic-pituitary-adrenal axis and the endogenous cannabinoid system may be involved in the immune regulatory role of acupuncture. Transcutaneous electrical acupoint stimulation is a new type of therapy which combined with the transcutaneous electrical nerve stimulation and acupoint. In order to observe the effects of TEAS on the incidence of SIRS as well as inflammatory cytokines after surgery, we applicated TEAS during perioperative time in patients with gastric cancer. Besides, we also observed the effects of TEAS on patients’ s pulmonary complications, anal exhaust time and hospitalization days after surgery. ObjectiveTo observe the effect of TEAS on the incidence of SIRS in patients undergoing radical surgery for gastric cancer. MethodsTotally 102 patients undergoing elective radical surgery for gastric cancer under general anesthesia were randomly assigned to three groups, control group, TEAS group and sham group. TEAS group receiving TEAS before surgery, 1th day and 2nd day after surgery at 10 am. TEAS was given through electrodes attached to ZuSanli and SanYinjiao acupoints. The time for TEAS was 30 min. The electrodes were also attached to ZuSanli and SanYinjiao acupoints but without electrical stimulation in sham group. The routine treatment was used in control group. Incidence of SIRS in each group were compared.Venous blood samples from TEAS group and sham group were collected before electrical stimulation on the operation day, 1th day and 3rd day after surgery. Venous blood samples from control group were collected before general anesthesia induction, 1th day and 3rd day after surgery. Inflammatory cytokines index including interleukin-6(IL-6), interleukin-10(IL-10), Tumor Necrosis Factor-alpha(TNF-α), Monocyte Chemotactic Protein-1(MCP-1), and Immunoglobulin G and Immunoglobulin M were measured. The postoperative pulmonary complications, the hospitalization days after surgery and the anal exhaust time in each group were also compared. ResultsFinally, 87 patients were included for the test, 31 cases in TEAS group, 26 cases in Sham group and 30 cases in the control group. There were no significant differences between the general data set; There were no statistical differences in the incidence of SIRS following surgery in each group. When comparing the levels of cytokines following surgery, we observed that the peripheral blood IL-6, MCP-1 levels in TEAS group were decreased significantly compared with those of control group at 1 day after surgery. When comparing immunoglobulin levels after surgery, we established that the peripheral blood IgG and IgM levels were significantly lower compared to those of TEAS group at 1 day after surgery.There were no statistical differences in the postoperative pulmonary complications, the hospitalization days after surgery and the first anal exhaust time in each group. ConclusionTEAS partially reduced the postoperative inflammatory reaction and the immune suppression, but did not decreased the incidence of SIRS following surgery.