| Objective: The clinical randomized controlled trial was designed to investigate the effects of specified electroacupuncture treatment on the recovery of gastrointestinal function of female patients after cesarean section.By recording and analysing the Gastrointestinal activity before and after the specified electroacupuncture treatment,we have a intuitive knowledge of how electroacupuncture treatment can affect the gastrointestinal functions.Further through recording and analyzing the variation of intestinal peptide(VIP)and Motilin(MTL)levels before and after electroacupuncture treatment and calculating the correlation between VIP MTL and the recovery index of gastrointestinal functions,we further expore the possible mechanism of how electroacupuncture treatment affects the recovery of gastrointestinal functions.So that based on evidence-based medicine,we provide relevant evidence to support the evaluation of the clinical efficacy of electroacupuncture for gastrointestinal function recovery after cesarean section.Methods: Parturients after cesarean section from the department of obstetrics and gynecology are recruited as objects for the research.100 such patients are admitted according to the integration and elimination standards.Then they are randomly divided into 3 groups,electroacupuncture group,placebo group and non-treatment group.During the research same patients are removed from the research,finally each group have 30 patients successfully finishing the research.The electro acupuncture group: we use disposable sterile stainless steel needle,which length 65 mm,and handle length 30 mm,0.38 mm diameter(Suzhou Huatuo brand medical equipment company production 215005),When the patients take supine position,the local skin is disinfected,We have a right angle with the skin,15-35 mm,Adjust the direction and depth of the needle,the patient after the electro acupuncture(Germany Medicine Co.,Ltd.)output voltage is adjusted to "0",the wires are respectively connected to the two needle handle,turn on the power switch,with 50 Hz dilatational wave began to moderate transferred to patients can be tolerated,the needle for 30 minutes,after 6 hours per day for 2 times.Course of treatment lasted 3 days.Placebo needle group: we use disposable sterile stainless steel needle,which 0.20 x 20mm(Suzhou Huatuo brand company of medical apparatus and instruments of production 215005),to acupuncture in local skin,not the standard point in the two shoulders and two upper arms.needing depth <5mm.The acupuncture point had no effect on the function of gastrointestinal motility.In order to simulate the electro-acupuncture group electro-acupuncture,the needle is connected with the electrode,and the stimulation intensity is 0(no current).No manual stimulation.Non treatment group: not special treatment.Then we collect,record and analyse the relavant data that relects the gastrointestinal functions.For example,the first bowel sound,exhaust defecation time,postoperative gastrointestinal reaction,abdominal distention.We also detect the levels of VIP and MTL of the patients at the day before operation,the fist day and the 4th day after operation.Then we statistically analyse the data by comparing between different groups and also by conductiong correlation analysis between the hormones and the evalution index of recovery of gastrointestinal function.Results:By setting placebo needle group,the mental confort effect in the process of electro acupuncture treatment is also taken in to consideration.As it turned out,through out the process,there are no significance between the data collected form placebo needle group and that clooected from non-treatment group.The very result ruled out the element of mental confort on the recovery of astrointestinal function,thus the differences of gastrointestinal function indexes between Electro acupuncture group and non-treatment group are caused only by the electro acupuncture treatment itself.For the sake of simplicity,the comparation between placebo needle group and non-treatment group will not be repeated in the following report.(1)The comprehensive curative effect: the comprehensive efficiency is 93.5%compared with 80% in the non-treatment group.There is statistically significant difference on the curative effect(P<0.05)between the two groups.(2)The bowel sounds: there is statistically significant difference on the recovery time of bowel sounds and the time from first bowel sounds to the normal state(recovery time)between the two group;the mean value of recovery time for the electro acupuncture group is much shorter than non-treatment group,which is 3.66±1.46 and10.05±8.16,respectively.The results of bowel sound assessment also show statistically significant difference after the lectro acupuncture treatment between the two group.The evalution score is much improved after the treatment,suggesting the electro acupuncture treatment can accelerate the recovery of bowel sound.(3)The exhaust and defecation: there is statistically significant difference on the time of first exhaust and defecation as well as the time interval between first exhaust and defecation between the two groups.The mean value of first exhaust and defecation time and the time interval in between in the electro acupuncture group is much shorter than non-treatment group,suggesting the electro acupuncture treatment can accelerate the exhaust and defecation.(4)Abdominal distension and abdominal pain: there is statistically significant difference in the abdominal distension and abdominal pain after the treatment between the two groups.The evaluation index of postoperative abdominal distension and pain in electroacupuncture group are better than those of the non-treatment group,suggesting the electro acupuncture treatment can ease the abdominal distension and abdominal pain.(5)Gastrointestinal reaction: there is statistically significant difference in the gastrointestinal reaction after the treatment between the two groups.The evaluation index of gastrointestinal reaction in electroacupuncture group are better than those of the non-treatment group,suggesting the electro acupuncture treatment can alleviate the gastrointestinal reaction.(6)Lactation: there is statistically significant difference in first lactation time after treatment between the two groups.The mean value of first lactation time in the electroacupuncture group is earlier than that of the non-treatment group.Also there is statistically significant difference in the lactation level at 72 hours.The mean value of lactation level in the electroacupuncture group is larger than that of the non-treatment group.The results suggest the electro acupuncture treatment can advance the first lactation time and improve lactation level.(7)The level of vasoactive peptide(VIP): threre are no statistically significant differences in the VIP level before cesarean section and 1 day after between the two groups.However,there is statistically significant difference in VIP level at the 4th day between the two groups.The mean value of VIP level at the 4th day in the electroacupuncture group is smaller than that of the non-treatment group.The mean value of VIP level in electroacupuncture group is almost reduced to the value before cesarean section.The results suggest electro acupuncture treatment can reduce the VIP level faster than the non-treatment group.We also evaluate the correlation between VIP levels and the recovery of gastrointestinal function.The results show a negative correlation(about 0.2~0.5)between the VIP levels and gastrointestinal symptoms.(8)The level of Motilin(MTL): threre are no statistically significant differences in the MTL level before cesarean section and 1 day after between the two groups.However,there is statistically significant difference in MTL level at the 4th day between the two groups.The mean value of VIP level at the 4th day in the electroacupuncture group is larger than that of the non-treatment group.The results suggest electro acupuncture treatment can improve the MTL level.We also evaluate the correlation between MTL levels and the recovery of gastrointestinal function.The results show a very weak positive correlation between the MTL levels and gastrointestinal symptoms.Compared with the changes of VIP level in the process,the changes of MTL level is rather small and the correlation of MTL on gastrointestinal function recovery is rather weak.It is safe to assume that MTL level does not play a major role in the process of gastrointestinal function recovery.Conclusion: Electroacupuncture stimulating specified acupoints can accelerate the recovery of gastrointestinal functions after cesarean section.It is concluded a possible mechanism that electroacupuncture treatment improve gastrointestinal function by decreasing the VIP level after cesarean section. |
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