Objective: To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) for alleviating postoperative cough in lung cancer patients undergoing video-assisted thoracoscopic surgery.
Methods: A total of 110 patients with lung cancer undergoing video-assisted thoracoscopic surgery were randomly divided into a TEAS group (55 cases, 2 cases dropped out) and a sham-TEAS group (55 cases, 4 cases dropped out). In the TEAS group, TEAS was delivered 30 min before anesthesia and on day 1 to day 4 after operation separately, with disperse-dense wave, in frequence of 2 Hz/100 Hz. The acupoints included Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Hegu (LI 4), Lieque (LU 7) and Taixi (KI 3) on the both sides. In the sham-TEAS group, at the same time points and same acupoints as the TEAS group, the electrode pads were attached to the acupoints, but without electric stimulation. The interventions were given 30 min each time, once daily in the two groups. The incidence of cough and the scores of visual analogue scale (VAS) for cough on the first day (T1), the third day (T2), the fifth day (T3), 1 month (T4) and 3 months (T5) after operation, as well as the scores of the Leicester cough questionnaire (LCQ) on T4 and T5 were compared between the two groups; the contents of serum C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were detected before surgery (T0) and at T1, T2 and T3. The first flatus time, the first defecation time, the first ambulation time, the postoperative hospital day and the incidence of postoperative nausea and vomiting were compared between the two groups.
Results: Compared with the sham-TEAS group, the cough incidence at T3 and cough VAS scores at T1 to T5 were lower in the TEAS group (P<0.05, P<0.01), and the LCQ scores at T4 and T5 were higher (P<0.05). The serum contents of CRP, IL-6 and TNF-αat T1 to T3 in the TEAS group were lower than those of the sham-TEAS group (P<0.01). The first flatus time, the first defecation time and the first ambulation time were earlier (P<0.05, P<0.01); and the postoperative hospital day was shorter (P<0.05) and the incidence of postoperative nausea and vomiting was lower (P<0.05) in the TEAS group when compared with those of the sham-TEAS group.
Conclusion: TEAS relieves cough in lung cancer patients undergoing video-assisted thoracoscopic surgery, improves quality of life and promotes the early postoperative recovery.
目的：评价经皮穴位电刺激（TEAS）对胸腔镜肺癌术后咳嗽的缓解作用。方法：将110例接受胸腔镜肺癌手术的患者随机分为TEAS组（55例，脱落2例）和假TEAS组（55例，脱落4例）。TEAS组分别于麻醉前30 min、术后1~4 d接受TEAS治疗，穴取双侧肺俞、脾俞、肾俞、合谷、列缺、太溪，予疏密波，频率2 Hz/100 Hz；假TEAS组在相同时间、相同穴位粘贴电极片但无电刺激。均每次30 min，每日1次。比较两组患者术后第1天（T1）、术后第3天（T2）、术后第5天（T3）、术后1个月（T4）、术后3个月（T5）咳嗽发生率、咳嗽视觉模拟量表（VAS）评分及T4、T5莱斯特咳嗽问卷（LCQ）评分，检测术前（T0）、T1、T2、T3血清C反应蛋白（CRP）、白介素6（IL-6）、肿瘤坏死因子α（TNF-α）含量，比较术后首次排气时间、首次排便时间、首次下床活动时间、术后住院天数、术后恶心呕吐发生情况。结果：TEAS组T3时点咳嗽发生率及T1~T5时点咳嗽VAS评分低于假TEAS组(P<0.05，P<0.01)，T4、T5 时点LCQ评分高于假TEAS组（P<0.05）；T1~T3时点血清CRP、IL-6、TNF-α含量低于假TEAS组（P<0.01）；首次排气时间、首次排便时间、首次下床活动时间早于假TEAS组（P<0.05，P<0.01），术后住院天数短于假TEAS组（P<0.05），术后恶心呕吐发生率低于假TEAS组（P<0.05）。结论：TEAS可缓解胸腔镜肺癌术后咳嗽，提高患者生活质量，促进患者术后早期康复。.
Keywords: lung cancer; pneumonectomy; postoperative cough; transcutaneous electrical acupoint stimulation; video-assisted thoracoscopic surgery.