| 肖玉兰,齐科雷,王秀娟,等.数字化音乐电胃肠起搏对食管癌术后肠道屏障功能、炎症和氧化应激的影响[J].安徽医药,2020,24(7):1346-1351. |
| 数字化音乐电胃肠起搏对食管癌术后肠道屏障功能、炎症和氧化应激的影响 |
| Effect of digital music gastrointestinal electrical pacing on intestinal barrier function，inflammation and oxidative stress after esophageal cancer surgery |
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| DOI：10.3969/j.issn.1009?6469.2020.07.019 |
| 中文关键词: 食管肿瘤 音乐疗法 /方法 电刺激疗法 穴位疗法 胃肠活动 胃肠起搏 肠道屏障功能 炎症 氧化应激 |
| 英文关键词: Esophageal neoplasms Music therapy/methods Electric stimulation therapy Acupoint therapy Gastrointestinal motility Gastrointestinal pacing Intestinal barrier function Inflammation Oxidative stress |
| 基金项目:河北省医学科学研究重点课题计划( 20160084) |
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| 中文摘要: |
| 目的探讨数字化音乐电胃肠起搏对食管癌术后肠道屏障功能、炎症和氧化应激的影响。方法选取 2016年 3月至 2018年 6月于河北省胸科医院住院的 120例食管癌病人作为研究对象，分为四组，即 A、B、C和 D组， A组病人给予胃肠减压等一般治疗措施， B组病人在 A组的基础上给予足三里穴按摩， C组病人在 A组的基础上给予胃肠起搏， D组在 A组的基础上给予数字化音乐电胃肠起搏治疗，共治疗 7d。观察胃肠功能的恢复情况，包括肠鸣音恢复时间、排气时间、排便时间、胃管留置时间、胃液引流量；酶联免疫吸附试验检测血清中内毒素、二胺氧化酶( DAO)、紧密连接蛋白( Occludin)、闭锁小带蛋白( ZO?1)、肿瘤坏死因子 ?α(TNF?α)、白细胞介素 ?6(IL?6)、白细胞介素 ?8(IL?8)和白细胞介素 ?10(IL?10)的含量；蛋白质免疫印迹检测外周血单个核细胞中 Toll样受体 ?4(TLR4)/核因子 ?κB(NF?κB)信号通路的表达；黄嘌呤氧化酶法检测超氧化物歧化酶( SOD)的活性，硫代巴比妥酸法检测丙二醛( MDA)的含量。结果 D组的肠鸣音恢复时间( 36.20±5.15)h、排气时间( 52.87±4.51)h、排便时间( 73.42±6.92)h、胃管留置时间( 80.95±7.65)h、胃液引流量( 895.44±101.35)mL、内毒素( 5.37±2.40)ng/L、DAO(2.71±0.70)U/ L、Occludin(13.61±3.20)μg/L、ZO?1(23.55±3.60)μg/L、TNF?α(12.35±3.61)ng/L、IL?6(16.48±4.01)ng/L、IL?8(37.87±9.71)ng/L均低于 A组［(48.72±5.93)h，(68.17±6.45)h，(87.20±6.67)h，(97.34±8.19)h，(1334.50±211.80)mL，(11.83±3.62)ng/L，(3.69±0.53) U/L，(21.56±3.94)μg/L，(31.01±4.33)μg/L，(26.31±4.29)ng/L，(33.72±5.44)ng/L，(82.67±12.55)ng/L］、 B组［( 45.62±5.50)h,(63.48±6.70)h，(79.95±7.69)h，(91.17±6.89)h，(1180.46±196.15)mL，(8.55±2.19)ng/L，(3.31±0.64)U/L，(19.49±2.88)μg/L，(27.36±4.02)μg/L，(20.70±3.88)ng/L，(25.09±4.85)ng/L，(72.63±11.44)ng/L］、 C组［(41.04±6.11)h，(61.25±5.81)h，(77.29±7.13) h，(88.72±9.03)h，(1047.28±160.33)mL，(7.80±3.25)ng/L，(3.12±0.59)U/L，(15.51±3.49)μg/L，(28.11±4.52)μg/L，(17.65±3.24) ng/L，(26.67±5.03)ng/L，(65.51±13.10)ng/L］，且 B、C组低于 A组( P＜0.05)，但是四组间 IL?10的含量差异无统计学意义( P＞0.05)。 D组外周血单个核细胞中的 TLR4(0.44±0.11)和 NF?κB(0.28±0.13)蛋白表达量均低于 A组［(1.00±0.24)(1.00±0.21)］、 B组［( 0.86±0.15)(0.84±0.22)］、 C组［( 0.75±0.20)(0.45±0.16)］且 B、C组低于 A组( P＜0.05)。 D组血的 SOD含量清中，(418.50±36.22)U/L高于 A组( 363.62±24.01)U/L、 (385.09±30)U/L、C组( 391.33±27.44)U/L，且 B、C组高于 A组( P＜均，B组，.58，0.05)； D组血清中的 MDA含量( 5.11±0.66)μmol/L均低于 A组( 6.42±0.85)μmol/L、B组( 5.89±0.74)μmol/L、C组( 5.65±0.80) μmol/L，且 B、C组低于 A组( P＜0.05)。结论数字化音乐电胃肠起搏能够改善食管癌术后病人的肠道屏障功能，下调血清炎性因子含量和外周血单个核细胞中 TLR4/NF?κB信号通路的表达，降低氧化应激水平。 |
| 英文摘要: |
| Objective To explore the effect of digital music gastrointestinal electrical pacing on intestinal barrier function，inflam? mation and oxidative stress after esophageal cancer surgery.Methods A total of 120 patients with esophageal cancer hospitalizedin the Hebei Provincial Chest Hospital from March 2016 to June 2018 were selected as the research subjects and divided into 4 groups，namely group A，B，C and D.Patients in group A were given general treatment such as gastrointestinal decompression.Pa?tients in group B were given Zusanli massage on the basis of group A.Patients in group C were given gastrointestinal pacing on thebasis of group A.Patients in group D were given digital music gastrointestinal electrical pacing on the basis of group A.The therapylasted for 7 days.The recovery of gastrointestinal function was observed，including recovery time of intestinal sound，exhaust time， defecation time，indwelling time of gastric tube and gastric juice drainage volume.The levels of endotoxin，diamine oxidase(DAO)， Occludin，ZO?1，tumor necrosis factor?α(TNF?α)interleukin?6(IL?6)，interleukin?8(IL?8)and interleukin?10(IL?10)in serum weredetectedbyenzymelinkedimmunosorbentassa，y.The expression of Toll?like receptor 4(TLR4)/Nuclear transcription factor? κB(NF?κB)signaling pathway in peripheral blood mononuclear cells was detected by Western blotting.The activity of superoxide dismutase(SOD)was detected by xanthine oxidase method and the content of malondialdehyde(MDA)was determined by thiobar? bituric acid method.Results The recovery time of bowel sound(36.20±5.15)h，exhaust time(52.87±4.51)h，defecation time(73.42±6.92)h，indwelling time of gastric tube(80.95±7.65)h，gastric drainage volume(895.44±101.35)mL，endotoxin(5.37±2.40)ng/L，DAO(2.71±0.70)U/L，Occludin(13.61±3.20)μg/L，ZO?1(23.55±3.60)μg/L，TNF?a(12.35±3.61)ng/L，IL?6(16.48±4.01)ng/L and IL?8(37.87±9.71)ng/L in group D were lower than those in group A［(48.72±5.93)h，(68.17±6.45)h，(87.20±6.67)h，(97.34±8.19)h，(1334.50±211.80)mL，(11.83±3.62)ng/L，(3.69±0.53)U/L，(21.56±3.94)μg/L，(31.01±4.33)μg/L，(6.31±4.29)ng/L，(33.72±5.44) ng/L，(82.67±12.55)ng/L］，group B［(45.62±5.50)h，(63.48±6.70)h，(79.95±7.69)h，(91.17±6.89)h，(1180.46±196.15)mL，(8.55±2.19)ng/L，(3.31±0.64)U/L，(19.49±2.88)μg/L，(27.36±4.02)μg/L，(20.70±3.88)ng/L，(25.09±4.85)ng/L，(72.63±11.44)ng/L］group C［(41.04±6.11)h，(61.25±5.81)h，(77.29±7.13)h，(88.72±9.03)h，(1047.28±160.33)mL，(7.80±3.25)ng/L，(3.12±0.59)U/，L，(15.51±3.49)μg/L，(28.11±4.52)μg/L，(17.65±3.24)ng/L，(26.67±5.03)ng/L，(65.51±13.10)ng/L］，and the levels of above indi? cators in group B，C were lower than those in group A(P＜0.05)，but there was no statistical difference among the four groups(P＞ 0.05).The expression of TLR4(0.44±0.11)and NF?κB(0.28±0.13) in peripheral blood mononuclear cells of group D were lower than those of group A［(1.00±0.24)，(1.00±0.21)］，group B［(0.86±0.15)，(0.84±0.22)］，group C［(0.75±0.20)，(0.45±0.16)］，and the expression of TLR4 and NF?κB in group B，C were lower than thosein group A(P＜0.05).The level of SOD(418.50±36.22)U/L in group D were higher than that in group A(363.62±24.01)U/L，group B(385.09±30.58)U/L，group C(391.33±27.44)U/L，and the level of SOD in group B，C were higher than that in group A(P＜0.05)； the level of MDA(5.11±0.66)μmol/L in group D were lower than that in group A(6.42±0.85)μmol/L，group B(5.89±0.74)μmol/L，group C(5.65±0.80)μmol/L，and the level of MDA in group B，C were lower than those in group A(P＜0.05).Conclusion Digital music gastrointestinal electrical pacing can improve the intes?tinal barrier function of patients with esophageal cancer after operation，down?regulate the level of serum inflammatory factors andthe expression of TLR4/NF?κB signaling pathway in peripheral blood mononuclear cells，and reduce the level of oxidative stress. |
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