艾灸配合极泉弹拨预防恶性肿瘤患者PICC相关性上肢静脉血栓:随机对照试验  

Prevention from PICC-related venous thrombosis in the upper limbs of malignant tumor patients with moxibustion combined with plucking at Jiquan(HT 1):a randomized controlled trial

作　　者：邱玲[1] 梁晓一 郑玉玲[2] 刘春香 赖小青 朱丽影[3] QIU Ling;LIANG Xiao-yi;ZHENG Yu-ling;LIU Chun-xiang;LAI Xiao-qing;ZHU Li-ying(Department of Urology,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510230,Guangdong Province,China;Department of Radiotherapy,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510230,Guangdong Province,China;Department of Hematology,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510230,Guangdong Province,China)

机构地区：[1]广州医科大学附属第一医院泌尿外科,广东广州510230 [2]广州医科大学附属第一医院放疗科,广东广州510230 [3]广州医科大学附属第一医院血液科,广东广州510230

出　　处：《中国针灸》2022年第7期741-746,共6页Chinese Acupuncture & Moxibustion

基　　金：广东省中医药局科研项目:20182082。

摘　　要：目的:观察艾灸配合极泉弹拨预防恶性肿瘤患者经外周静脉置入中心静脉导管(PICC)相关性上肢静脉血栓的临床效果。方法:将80例行PICC的恶性肿瘤患者随机分为观察组和对照组,每组40例。对照组实施PICC常规护理;观察组在常规护理基础上行艾灸配合极泉弹拨,首先于PICC静脉走行处(避开穿刺点)行温和灸10~15 min,然后于曲池、血海和天府穴行回旋灸(每穴3~5 min),最后弹拨极泉5~10 min,于PICC后第2天开始治疗,每日1次,每周5次,共治疗3周。比较两组置管后第42天置管侧上肢PICC相关性静脉血栓发生率;置管后第2、7、14、21、28、35、42天,观察两组置管侧锁骨下静脉收缩期峰值流速(PSV)和舒张末期流速(EDV)。结果:观察组PICC相关性上肢静脉血栓发生率低于对照组[2.5%(1/40)vs 17.5%(7/40),P<0.05]。置管后第7、14、21、28、35天,观察组置管侧锁骨下静脉PSV高于置管后第2天(P<0.05);置管后第28、42天,对照组置管侧锁骨下静脉PSV低于置管后第2天(P<0.05);置管后第7、14、21、28天,观察组置管侧锁骨下静脉EDV高于置管后第2天(P<0.05);置管后第28、35、42天,对照组置管侧锁骨下静脉EDV低于置管后第2天(P<0.05);置管后第7、14、21、28、35、42天,观察组置管侧锁骨下静脉PSV和EDV均高于对照组(P<0.01,P<0.05)。结论:艾灸配合极泉弹拨可有效预防恶性肿瘤患者PICC相关性上肢静脉血栓的形成,改善患者的静脉血流速度。Objective To observe the clinical effect of moxibustion combined with plucking technique at Jiquan(HT 1)for preventing peripherally inserted central catheter(PICC)-related venous thrombosis in the upper limbs of malignant tumor patients.Methods A total of 80 malignant tumor patients undergoing PICC were randomized into an observation group and a control group,40 cases in each one.In the control group,the routine care for PICC was exerted.In the observation group,besides the routine care,moxibustion combined with plucking technique at Jiquan(HT 1)was added.Mild moxibustion was exerted along the venous distribution of PICC(avoiding the entry site)for 10 to 15 min,and then,the circling moxibustion was applied to Quchi(LI 11),Xuehai(SP 10)and Tianfu(LU 3),3 to 5 min at each acupoint.Finally,plucking technique was given at Jiquan(HT 1)for 5 to 10 min.This combined therapy was intervened since the 2 nd day of PICC placement,once daily,5 times a week,for 3 weeks totally.The incidence of the PICC-related venous thrombosis in the upper limbs was compared between the two groups on day 42 of placement.On day 2,7,14,21,28,35 and 42 of PICC placement,the peak systolic velocity(PSV)and the end-diastolic velocity(EDV)of the subclavicular vein on the placement side were observed separately in the two groups.Results The incidence of the PICC-related venous thrombosis in the upper limbs in the observation group was lower than that in the control group(2.5%[1/40]vs 17.5%[7/40],P<0.05).From day 7 to 35 of PICC placement,PSV of the subclavicular vein on the placement side was higher than that on the day 2 of PICC placement in the observation group(P<0.05).On day 28 and 42 of PICC placement,PSV of the subclavicular vein on the placement side was lower than that on the day 2 of PICC placement in the control group(P<0.05).In the observation group,EDV of the subclavicular vein on the placement side was higher than that on the day 2 of PICC placement from day 7 to 28 of PICC placement(P<0.05).In the control group,EDV of the subclavicular

关 键 词：恶性肿瘤 经外周静脉置入中心静脉导管(PICC) PICC相关性上肢静脉血栓 艾灸 穴 极泉 弹拨 

分 类 号：R246.2[医药卫生—针灸推拿学]