| Objective: Through randomized controlled clinical trial,the research has studied whether the electroacupuncture stimulating specific acupoints can have impact on the recovery of gastrointestinal function after cesarean section.Through detecting and analyzing the change level of vasoactive intestinal peptide(VIP)before and after electroacupuncture treatment,we attempt to study the influence of Electroacupuncture on the secretion level of these two kinds of gastrointestinal peptide,and discover the correlation between gastrointestinal hormones and the recovery index of gastrointestinal function.The probable influence mechanism is further discussed and explored in the clinical research,which can naturally provide relevant evidence supports on evaluating the clinical effect of electroacupuncture on the gastrointestinal function recovery after cesarean section based on evidence-based medicine.Methods: In the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,parturients after cesarean section from the department of obstetrics and gynecology are recruited as objects for the research.Based on the the integration and elimination standards,70 samples is obtained according the order of entry into the study.Then,according the random table and grouping rules,they are finally divided into two groups,namely electroacupuncture group and control group,which are composed of 35 parturients respectively.In the process,some samples are removed and eliminated,and 31 objects belonged to acupuncture group,29 objects belonged to control group are successfully completed at last.In the electroacupuncture group,the parturients are treated by acupuncturing the bilateral Zusanli,Shangjuxu,Gongsun,Neiguan acupoint,when 6h after cesarean section.The acupuncturing operation consecutively carried out for 3 days,two times per day and about 30 minutes per every time,two times per day.The control group is not treated with electroacupuncture.Then,the relevant data of evaluation index,such as the time of first bowel sound,recovery time of bowel sounds,the time of first exhaust defecation time,postoperative gastrointestinal reaction,abdominal distention,and lactation are observed and recorded in detail.Meanwhile,the levels of vasoactive peptide(VIP)are detected in three time slots,which are the day before operation,the first day after operation and the fourth day morning after operation.Using statistical analysis method to deal with the data collected,we can evaluate the effect of Electroacupuncture on gastrointestinal function recovery by comparison.In addition,the correlation between gastrointestinal hormones and gastrointestinal function recovery is acquired to investigate the influence mechanism of electroacupuncture on the gastrointestinal function recovery.Result:(1)The comprehensive curative effect: In the electroacupuncture treatment group,there are 12 effective parturients,3 cured parturients,14 improved parturients,and 2 ineffective parturients,the comprehensive efficiency is 93.5%.Meanwhile,in the control group,there are 8 effective parturients,4 cured parturients,12 improved parturients,and 5 ineffective parturients,the comprehensive efficiency of 83%.Hence,there exist statistically significant differences on the curative effect(P<0.05)between the two groups.Meanwhile,in the two groups,there is no significant difference on the scores of curative effect before treatment(P=0.856),but there exist significant difference(P<0.05)on the evaluation after treatment(P=0.008),difference value before and after treatment(P=0.005),effect index(P=0.012).The scores after treatment 0.456±0.458,difference value before and after treatment-1.147±0.757,effect index 65.32±7.65 in electroacupuncture group are better than these of the control group,which are 1.036±0.248,-0.513±0.665,48.54±8.24 respectively.(2)The bowel sounds: There are actually no significant differences on the time of first bowel sounds(P=0.073),however,there exist significant differences on the recovery time(P=0.001),the time required to return to the normal state(P=0.001)between two groups.The recovery time 11.9678±4.446,the time required to return to the normal state 3.807±2.227 in electroacupuncture group are better than these of control group,which are 17.069±6.590,6.3793±3.416.Moreover,there exist no significant differences on the bowel sounds assessment before treatment(P=0.636),but have naturally obvious differences and on assessment after treatment(P=0.019)and the difference value(P=0.000)before and after treatment.It proves that acupuncture can advance the time of fist bowel sounds and normal state,and short the cycle of recovery.(3)The time of first exhaust and defecation: In the two groups,there exist significant difference on the time of first exhaust(P=0.006)and defecation(P=0.001),and the time difference(P=0.005)between exhaust time and defecation time.And the difference in the defecation time and the time difference are significantly higher.Moreover,the time of first exhaust 18.290±7.212,first defecation 22.839±7.165,and the time difference between first exhaust and defecation 4.549±2.718 in electroacupuncture group are better and earlier than these of control group,which are 28.552±18.621,35.586±19.813,7.035±3.756.The electroacupuncture treatment needs a certain period to reflect its efficacy,after a period of treatment,it can promote the recovery of gastrointestinal function,effectively early the defecation time and short the time difference.(4)Abdominal distension and abdominal pain: By comparing the two groups,there is no significant difference on the evaluation of abdominal distension(P=0.729)and abdominal pain(P=0.995)before treatment.However,there exist significant difference on postoperative abdominal distension assessment(P=0.004),the distension difference value before and after operation(P=0.000),postoperative abdominal pain(P=0.005),the pain difference value before and after treatment(P=0.002)in the two groups.The postoperative abdominal distension 0.419±0.807 and pain 0.452±0.810 in electroacupuncture group are better than these of control group,which are 1.103±0.940,1.1034±0.940.Moreover,the difference value of distension-1.097±0.790 and pain-1.064±0.854 before and after treatment in electroacupuncture group are better than these of control group,which are-0.345±0.553,-0.414±0.682 respectively.(5)Gastrointestinal reaction: In the two groups,there exist no significant differences(P>0.05)on the gastrointestinal reaction(P=0.236)before treatment,it means that the symptoms of nausea and vomiting in the two groups are similar before treatment.However,there exist great differences(P<0.05)on the gastrointestinal reaction assessment(P=0.001)after treatment,the difference value(P=0.005)before and after treatment.Moreover,the assessment scores of gastrointestinal reaction 0.226±0.49730 after treatment,and the difference value-0.420±0.502 in electroacupuncture group are better than these of control group,which are 0.759±0.636,-0.103±0.310 respectively.(6)Lactation level: In the two groups,there exist significant differences(P>0.05)on the initial time of colostrum(P=0.017)after operation,the time of initial colostrum is 21.677±16.070 in electroacupuncture group,which is earlier than that of control group 33.897±22.228.Meanwhile,we also found that there is no significant difference(P>0.05)on the lactation level in initial(P=0.067)and 48 hours(P=0.154).The possible reason is that acupuncture treatment needs some time to release its effect.At 72 hours,there is significant difference(P<0.05)on the comprehensive lactation level(P=0.009)between the two groups.Moreover,the lactation level at 72 is 1.749±0.733 in electroacupuncture group,which is higher than that of control group 1.102±0.621.(7)The change level of vasoactive peptide: Through comparative analysis,there are no significant differences(P>0.05)on the vasoactive peptide level(P=0.751)before operation,first day after operation(P=0.938),the difference value(P=0.502)before and after operation.And the difference value are 120.8031±49.98738,111.260±59.2891 in two groups,the vasoactive peptide level increase greatly after operation in both two groups.However,there are obvious differences(P<0.05)on the vasoactive peptide level of fourth day after operation(P=0.039),the difference value(P=0.025)between first day and fourth day after operation in two groups.Moreover,the vasoactive peptide level 205.5289±91.82616 of fourth day after the treatment in electroacupuncture group is lower than that of control group 256.593±95.054.And the difference value-110.138±47.044 between first day and fourth day after operation in acupuncture group are higher than that of control group-57.172±54.950.In addition,the vasoactive peptide after the treatment 205.529±91.826 is more closed to its level 194.864±92.322 before operation.(8)The correlation between gastrointestinal hormones and gastrointestinal function recovery: the research discover that there exist a negative correlation between the VIP after treatment,the difference value of VIP and the majority of gastrointestinal symptoms,but there is no significant correlation between with the VIP after treatment,the difference value of VIP and lactation time.Conclusion: Electroacupuncture as a treatment tool,it can not only effectively shorten the first exhaust defecation time for cesarean section,relieve abdominal distention nausea and vomiting symptoms,but also promote bowel sounds recovery and improve the recovery effect of gastrointestinal function after cesarean section.There is a negative correlation between the vasoactive peptide level and the recovery of gastrointestinal function.The possible influence mechanism of electroacupuncture on gastrointestinal function recovery is that acupuncture stimulation can reduce vasoactive peptide,which will improve the symptoms of gastrointestinal function after cesarean section. |
PDF Full Text Request