小剂量吗啡内关穴注射治疗急性心肌梗死之胸痛  

Clinical observation on injection of small dose of Morphine into Neiguan (PC 6) for treatment of chest pain in the patient with acute myocardial infarction

作　　者：张雪羽[1] 李文慧[1] 温塘芳[1] 李春海[1] 程铮[1] 张秀丽[1] 苏心镜[1] 

机构地区：[1]河北北方学院附属第二医院心内科,张家口075100

出　　处：《中国针灸》2008年第9期642-644,共3页Chinese Acupuncture & Moxibustion

摘　　要：目的:探寻治疗急性心梗胸痛时吗啡的有效注射途径。方法:将临床确诊为心肌梗死的患者90例随机分为3组,每组30例。穴位注射组行双侧内关穴分别注射吗啡2 mg,静脉注射组采用吗啡5 mg静脉注射,皮下注射组采用吗啡5 mg皮下注射,其他治疗3组相同。采用视觉模拟评分法(VAS)观察3组病人治疗5、10、30、60、180 min后镇痛效果,并记录并发症。结果:治疗前3组VAS评分比较差异无统计学意义(均P>0.05);治疗后5 min、30 min、180 min镇痛效果穴位注射组优于其他2组(均P<0.01);穴位注射组恶心、呕吐发生率为3.3%,低于静脉注射组的40.0%和皮下注射组的20.0%(均P<0.01)。结论:小剂量吗啡内关穴注射治疗急性心梗时的胸痛疗效确切,镇痛效果好,吗啡用量少,镇痛时间长,吗啡并发症少。Objective To probe into an effective injection way of Morphine for treatment of chest pain of acute cardiac infarction.Methods Ninety cases of myocardial infarction were randomly divided into 3 groups,an acupoint-injection group,an intravenous injection group and a hypodermic injection group,30 cases in each group.The acupoint-injection group were treated with injection of 2 mg Morphine into bilateral Neiguan（PC 6） respectively,and the intravenous injection group with intravenous injection of 5 mg Morphine and the hypodermic injection group with hypodermic injection of 5 mg Morphine,and other treatments were same in the 3 groups.The analgesic effects were assessed with visual analogue scale（VAS） 5,10,30,60 and 180 minutes after treatment and the complications were observed.Results There were no significant differences among the 3 groups before treatment in the VAS score（P〉0.05）.The analgesic effect in the acupoint-injection group was better than those in other two groups 5 min,30 min and 180 min after treatment（all P〈0.01）.The incidence rate of nausea and vomiting of 0.3% in the acupoint-injection group was significantly lower than 40.0% in the intravenous injection group and 20.0% in the hypodermic injection group（all P〈0.01）.Conclusion Injection of small dose of Morphine into Neiguan（PC 6） has a definite therapeutic effect on chest pain of acute myocardial infarction with earlier analgesic effect,smaller dose of Morphine,longer analgesic duration and less complications.

关 键 词：穴 内关 穴位注射 吗啡 心肌梗塞 胸痛 针刺镇痛 

分 类 号：R246.1[医药卫生—针灸推拿学]