针刺对鼻内镜术后疼痛及应激反应指标的影响  

Effect of Acupuncture on Pain and Stress Response Indicators After Endoscopic Sinus Surgery

作　　者：臧明丽 于阅尽[1] 彭生[1] 黄卫[1] 郝亚楠[1] ZANG Mingli;YU Yuejin;PENG Sheng;HUANG Wei;HAO Yanan(Shanghai University of Traditional Chinese Medicine Seventh People’s Hospital,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《上海针灸杂志》2022年第3期268-273,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市浦东新区国家中医药发展综合改革试验区建设项目中医薄弱学科建设项目(耳鼻喉科)(PDZY-2020-0401)。

摘　　要：目的观察针刺对鼻内镜术后疼痛及应激反应指标的影响。方法将84例鼻内镜手术术后鼻腔填塞患者随机分为治疗组和对照组,每组42例。对照组术后采用止血海绵双侧鼻腔填塞压迫止血48 h,治疗组在对照组治疗的基础上采用连续2 d针刺镇痛。观察术后3 h和术后第2天(T2)VAS疼痛评分和中医证候疼痛积分变化,观察两组手术前(T0)、术后第1天(T1)、T2血浆皮质醇(Cort)和促肾上腺皮质激素(ATCH)的水平,并比较两组的临床疗效。结果治疗组T2 VAS评分和中医证候积分较术后3 h显著降低(P<0.01);治疗组低于对照组(P<0.01)。治疗组T2时间点血浆Cort和ATCH浓度低于T0和T1(P<0.05),且治疗组T2时间点血浆Cort和ATCH浓度低于对照组(P<0.05)。治疗组总有效率高于对照组(P<0.01)。结论针刺可显著减轻鼻内镜术后鼻腔填塞患者的疼痛,可能与下调血浆Cort和ACTH水平有关。Objective To observe the effect of acupuncture on pain and stress response indicators after endoscopic sinus surgery.Method Eighty-four patients with nasal packing after endoscopic sinus surgery were randomized to treatment and control groups,with 42 cases in each group.The control group received bilateral nasal packing with hemostatic sponge for 48-hour compression hemostasis and the treatment group,two consecutive days of acupuncture analgesia in addition.The pain VAS score and the TCM syndrome pain score were recorded at 3 hrs and two days(T2)after surgery.Plasma cortisol(Cort)and adrenocorticotropic hormone(ATCH)levels were measured in the two groups before surgery(T0)and at one(T1)and two days(T2)after.The clinical therapeutic effects were compared between the two groups.Result The VAS score and the TCM syndrome pain score decreased significantly in the treatment group at T2 compared with 3 hrs postoperatively(P<0.01)and were lower than in the control group(P<0.01).Plasma Cort and ATCH levels were lower in the treatment group at T2 than at T0 and T1(P<0.05)and lower than in the control group at T2(P<0.05).The total efficacy rate was higher in the group than in the control group(P<0.05).Conclusion Acupuncture can effectively relieve pain in patients with nasal packing after endoscopic sinus surgery,which may be related to down-regulating plasma Cort and ATCH levels.

关 键 词：针刺疗法 针刺镇痛 鼻外科手术 疼痛 术后 应激 

分 类 号：R246.2[医药卫生—针灸推拿学]