针刺次髎穴改善肛肠术后疼痛水肿的效果及相关疼痛介质、炎性因子水平的变化  

Effect of Acupuncture at Ciliao(BL32) on Pain and Edema after Anorectal Surgery and Changes in Levels of Related Pain Mediators and Inflammatory Factors

作　　者：张平[1] 薛京花 寇文平 ZHANG Ping;XUE Jinghua;KOU Wenping(Shanxi Provincial Peoples Hospital,Taiyuan 030012,Shanxi,China)

机构地区：[1]山西省人民医院,山西太原030012

出　　处：《中华中医药学刊》2022年第10期87-90,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：中华医学会临床医学科研专项基金(198605935217);山西省卫生健康委科研项目(2018095)。

摘　　要：目的 研究针刺次髎穴改善肛肠术后疼痛水肿的效果及相关疼痛介质、炎性因子水平变化作用机制。方法 采用随机便利法抽取2019年1月—2021年4月医院结直肠肛门外科行结直肠手术患者80例作为研究对象,按照手术先后顺序,采用单双号法将纳入患者分为观察组和对照组(各40例)。对照组给予中药熏洗坐浴治疗,观察组在上述基础上联合针刺次髎穴,1次/d,连续7 d。观察和比较两组患者治疗前(T0)及治疗3 d(T1)、治疗7 d(T2)后疼痛评分、水肿评分和疼痛介质[血清前列腺素E(prostaglandin E2,PGE)、β内啡肽(β-endorphin,β-EP)]、炎性因子[白介素-1β(interleukin-1β,IL-1β)、白介素-8(interleukin-18,IL-8)]水平变化。结果 观察组患者临床痊愈率45.00%(18/40)、总有效率97.50%(39/40)分别高于对照组[30.00%(12/40)、82.50%(33/40)],无效率2.50%(1/40)低于对照组[17.50%(7/40)],差异有统计学意义(P<0.05)。两组患者疼痛评分、水肿评分及PGE、IL-1β、IL-8水平均呈下降趋势,β-EP水平呈升高趋势,差异有统计学意义(P<0.05);T1、T2时观察组疼痛评分、水肿评分及PGE、IL-1β、IL-8水平均低于对照组,β-EP水平高于对照组,差异有统计学意义(P<0.05)。结论 针刺次髎穴通过疏通经络、泻热宣畅等方式能使肛肠术后患者气血畅通、阴阳调和而有助于减少疼痛介质和炎性因子大量释放,继而实现改善肛肠术后创面疼痛水肿等目标,具有可靠的治疗优势。Objective To study the effect of acupuncture at Ciliao(BL32) on improving pain and edema after anorectal surgery and the mechanism of the changes in the levels of related pain mediators and inflammatory factors. Methods A randomized convenience method was used to select 80 patients who underwent colorectal surgery from January 2019 to April 2021 in the colorectal and anal surgery department of the hospital. According to the order of surgery, the included patients were divided into observation group and control group by using the odd and even number method(40 cases per group). The control group was given traditional Chinese medicine fumigation, washing and sitz bath treatment, and the observation group was combined with acupuncture at Ciliao(BL32) on the basis of the above, once a day, for 7 consecutive days. Pain score, edema score and pain mediators[serum prostaglandin E2(PGE2),β-endorphin(β-EP)],inflammation factors[interleukin-1β(IL-1β),interleukin-8(IL-8)]before treatment(T0),3 day(T1) and 7 days(T2) after treatment in the two groups were observed and compared. Results The clinical cure rate of patients in the observation group was 45.00%(18/40) and the total effective rate was 97.50%(39/40),which were higher than those of the control group[30.00%(12/40),82.50%(33/40)],and the inefficiency was 2.50%(1/40) which was lower than 17.50%(7/40) of the control group. The difference was statistically significant(P<0.05). The pain score, edema score, levels of PGE2,IL-1β and IL-8 of the two groups showed a downward trend, and the β-EP level showed an upward trend, and the difference was statistically significant(P<0.05). The pain score, edema score, levels of PGE2,IL-1β and IL-8 in the observation group at T1 and T2 were lower than those in the control group, and β-EP level was higher than that in the control group. The difference was statistically significant(P<0.05). Conclusion Acupuncture at Ciliao(BL32) can unblock the meridians, purge heat and promote dispersing to make the Qi and blood of patients after

关 键 词：肛肠术后 针刺 次髎穴 疼痛 水肿 疼痛介质 炎性因子 

分 类 号：R245.3[医药卫生—针灸推拿学]