耳穴贴压对肺部分切除术患者围手术期镇痛效果观察  

Effect of auricular point sticking therapy on perioperative pain in patients with partial lung resection

作　　者：李英 杜金龙 郝蓬亮 张梦雪 姜岳波 舒曼 关玲 LI Ying;DU Jin-long;HAO Peng-liang;ZHANG Meng-xue;JIANG Yue-bo;SHU Man;GUAN Ling(Department of Acupuncture and Moxibustion,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Qinghai Armed Police Force Hospital;China News of TCM)

机构地区：[1]中国人民解放军总医院第一医学中心针灸科,北京100853 [2]青海武警总队医院 [3]中国中医药报社

出　　处：《中国针灸》2021年第6期603-607,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:观察耳穴贴压对肺部分切除术患者围手术期的镇痛作用。方法:将92例肺部分切除术患者随机分为耳穴组(31例,脱落1例)、假耳穴组(30例)、药物组(31例,脱落1例)。3组均予常规药物镇痛治疗。耳穴组于术前1 d选取神门、交感、皮质下、脑干、垂前、胸、肺进行耳穴贴压,保留至术后3 d;假耳穴组贴压不带王不留行籽的耳穴贴,方法同耳穴组。记录各组患者术后8、16、24、48、72 h视觉模拟量表(VAS)评分,术后VAS评分均数低于3分的时间;术后8、72 h医院焦虑抑郁量表(HAD)评分;术后24、48 h血浆β-内啡肽(β-EP)浓度,并记录各组患者术后不良反应。结果:术后8、16、24、48、72 h,耳穴组VAS评分低于假耳穴组和药物组(P<0.05)。耳穴组VAS评分均数于术后16 h后低于3分,假耳穴组与药物组在术后48 h后VAS评分均数低于3分。术后8、72 h,耳穴组焦虑、抑郁评分低于假耳穴组和药物组。术后24、48 h,耳穴组血浆β-EP浓度均高于假耳穴组和药物组(P<0.05);术后24 h,假耳穴组血浆β-EP浓度高于药物组(P<0.05)。耳穴组不良反应发生率低于假耳穴组和药物组(P<0.05)。结论:耳穴贴压可以缓解肺部分切除术患者围手术期疼痛,缩短镇痛时间,缓解焦虑和抑郁情绪,减少术后不良反应,其镇痛机制可能与升高血浆β-EP浓度有关。Objective To observe the analgesic effect of auricular point sticking therapy during the perioperative stage in the patients with partial lung resection.Methods A total of 92 patients with partial lung resection were randomized into an auricular point group(31 cases,1 case dropped off),the sham-auricular point group(30 cases)and a medication group(31 cases,1 case dropped off).The routine medication for analgesia was provided in all of the three groups.In the auricular point group,1 day before operation,the auricular point sticking therapy was applied at shenmen(TF_(4)),sympathetic(AH_(6a)),subcortex(AT_(4)),brain stem(AT_(3,4i)),anterior ear lobe(LO_(4)),chest(AH_(10))and lung(CO_(14)),retained till the third day after operation.In the sham-auricular point group,the auricular adhesive tape without semen vaccariae was used at the same points as the auricular point group.Separately,the scores of visual analogue scale(VAS)in 8,16,24,48 h and 72 h after operation,the time for obtaining the mean of the postoperative VAS score<3 points,the scores of hospital anxiety and depression scale(HAD)in 8,72 h after operation and the plasma concentration of β-endorphin in 24,48 h after operation,as well as the adverse reactions after operation were recorded in the patients of each group.Results In 8,16,24,48 h and 72 h after operation,VAS scores in the auricular point group were lower than those in the sham-auricular point group and the medication group separately(P<0.05).In the auricular point group,16 h after operation the mean of VAS score was less than 3 points,but in the sham-auricular point group and the medication group,48 h after operation,such a mean score of VAS was obtained.In 8,72 h after operation,HAD score in the auricular point group was lower than that in the sham-auricular point group and the medication group respectively.In 24,48 h after operation,the concentration of plasma β-endorphin was all higher than that in the sham-auricular point group and the medication group respectively(P<0.05).In 24 h after opera

关 键 词：围手术期疼痛 耳穴贴压 血浆β-内啡肽(β-EP) 镇痛 

分 类 号：R246.2[医药卫生—针灸推拿学]