电针内麻点镇痛用于治疗癌症疼痛的临床研究  

Clinical trial of electroacupuncture at Neimadian-point for cancer pain

作　　者：韩学昌[1] 邢群智[1] 李毓[1] 董旭[1] 马孝武[1] 张露[1] 王前前 HAN Xue-chang;XING Qun-zhi;LI Yu;DONG Xu;MA Xiao-wu;ZHANG Lu;WANG Qian-qian(Department of Anesthesiology,The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院麻醉科,河南洛阳471003

出　　处：《针刺研究》2020年第10期845-850,共6页Acupuncture Research

基　　金：河南省教育厅科学技术研究重点项目(No.12B320009,教科技[2012]114号)。

摘　　要：目的:观察电针刺激内麻点治疗癌疼痛镇痛的有效性和安全性,并探讨其镇痛机制。方法:将癌症疼痛患者140例随机分为电针组和对照组,每组70例。电针组给予电针针刺内麻点镇痛+镇痛泵镇痛(仅0.9%氯化钠溶液);对照组给予舒芬太尼静脉自控镇痛+安慰电针非针刺镇痛。两组均于每天早上8点开始治疗,记录治疗前1h(T0),第1天治疗后1h(T1)、8h(T2)、24h(T3),第2天治疗后1h(T4)、8h(T5)、24h(T6)各时点的镇痛效果。检测患者血浆中炎性因子去甲肾上腺素、五羟色胺及亮脑啡肽、β-内啡肽、强啡肽A1-13的含量,并评价两组的安全性。结果:与治疗前T0比较,两组患者治疗后各时点的VAS评分,血浆中去甲肾上腺素、五羟色胺含量均明显降低(P<0.05),电针组血浆中亮脑啡肽、β-内啡肽、强啡肽A1-13含量均明显升高(P<0.05),对照组血浆中亮脑啡肽、β-内啡肽、强啡肽A1-13含量明显降低(P<0.05)。电针组T1、T2、T4、T5时点的VAS评分及血浆中去甲肾上腺素、五羟色胺含量明显低于对照组(P<0.05),治疗后T1、T2、T4、T5时点的镇痛疗效及各时点血浆中亮脑啡肽、β-内啡肽、强啡肽A1-13含量明显高于对照组(P<0.05,P<0.01)。两组治疗安全性等级比较,电针组明显高于对照组(P<0.001)。结论:电针刺激内麻点镇痛治疗癌症疼痛简便、安全、经济,且效果显著,大大提高了癌痛患者的生活质量。Objective To observe the clinical efficacy and safety of electroacupuncture(EA)at Neimadian-point for cancer pain.Methods A total of 140cancer patients with pain were randomly divided into EA and control groups,with 70cases in each group.The patients of the EA group received EA at Neimadian-point plus analgesia pump(all prepared with normal saline).The patients of the control group were treated by Sufentanil patient-controlled intravenous analgesia plus sham EA(without stimulation).The treatment was conducted once daily for two days at 8o’clock every morning.Respectively,in 1hbefore treatment(T0),1h(T1),8h(T2),24h(T3)after treatment of the first day,1h(T4),8h(T5),24h(T6)after treatment of the second day,the visual analogue scale(VAS)score of pain,and the plasma levels of norepinephrine,5-HT,leucine enkephalin,β-endorphin and dynorphin A1-13were tested.The security level(1—4grade)was assessed during the treatment.Results Compared with their own pre-treatment,in T1to T6,the VAS scores,and the contents of plasma norepinephrine and 5-HT obviously decreased in both groups(P<0.05),and the contents of leucine enkephalin,β-endorphin and dynorphin A1-13all increased(P<0.05)in the EA group.The analgesia effects were significantly higher in the EA group than in the control group in T1,T2,T4and T5(P<0.05,P<0.01).The therapeutic effect of EA at Neimadian-point was significantly superior to that of the Sufentanil in down-regulating plasma norepinephrine and 5-HT levels,and in up-regulating leucine enkephalin,β-endorphin and dynorphin A1-13levels(P<0.05,P<0.01).Conclusion EA at Neimadian-point can effectively relieve the pain of cancer patients and improve their quality of daily life.

关 键 词：电针 内麻点 镇痛 癌症 疼痛 

分 类 号：R245.97[医药卫生—针灸推拿学]