腕踝针联合吴茱萸热熨疗法改善PCNL术后疼痛的效果观察  

Wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing in treating pain after PCNL

作　　者：陈敏[1,2] 陈金兰 朱锐[1,2] 梁斯扬 苏郑明 卞军 周楚善[3] 冯梓华 Chen Min;Chen Jinlan;Zhu Rui;Liang Siyang;Su Zhengming;Bian Jun;Zhou Chushan;Feng Zihua(Department of Urological Surgery,The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China;Key Laboratory of Biological Targeting Diagnosis,Therapy,and Rehabilitation,Guangdong Higher Education Institutes,Guangdong 510700,China;The Fifth Clinical College of Guangzhou Medical University,Guangzhou 510700,China)

机构地区：[1]广州医科大学附属第五医院泌尿外科,广州510700 [2]广东高校生物靶向诊治与康复重点实验室,广州510700 [3]广州医科大学第五临床学院,广州510700

出　　处：《国际医药卫生导报》2022年第23期3316-3320,共5页International Medicine and Health Guidance News

基　　金：广东省中医药局科研项目(20211250);广东高校生物靶向诊治与康复重点实验室(2021KSYS009);广东省医学科研项目(A2021351);广州市医学重点学科项目(2021-2023);广州医科大学临床重点专科(广医大发〔2020〕5号)。

摘　　要：目的探讨腕踝针联合吴茱萸热熨疗法在改善经皮肾镜碎石取石术(percutaneous nephrolithotomy,PCNL)术后患者疼痛中的临床疗效。方法本研究采用随机对照试验,选取2021年1月1日至2022年5月30日在广州医科大学附属第五医院泌尿外科行PCNL治疗的120例患者,随机数字表法分为4组,每组30例。双氯芬酸钠组男17例、女13例,年龄(51.68±5.88)岁;腕踝针组男20例、女10例,年龄(49.91±6.71)岁;吴茱萸组男18例、女12例,年龄(50.28±8.33)岁;腕踝针联合吴茱萸组男17例、女13例,年龄(49.07±8.91)岁。比较4组治疗前后疼痛数字评定量表(NRS)评分、镇痛起效时间、镇痛保持时间以及不良反应。计量资料采用方差分析事后检验,计数资料采用χ2检验。结果4组患者的初始疼痛评分比较,差异无统计学意义(P=0.305)。腕踝针联合吴茱萸组在干预5 min后即可见显著疗效,15 min后初始疼痛评分平均分由3.10分下降至1.12分,持续至120 min时NRS评分为0.68分,该组患者疼痛评分下降幅度最大;腕踝针组单独镇痛时下降曲线缓慢;吴茱萸组在干预60 min后疼痛评分结果回升;双氯芬酸钠组在干预15 min内未见明显缓解,出现恶心呕吐1例,后可自行缓解,其余3组均未出现相应并发症。结论腕踝针联合吴茱萸热熨能有效改善PCNL术后疼痛,安全性好,起效迅速且作用持久。Objective To investigate the clinical effect of wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing in reducing pain score in patients after percutaneous nephrolithotomy(PCNL).Methods One hundred and twenty patients who underwent PCNL in Department of Urological Surgery,The Fifth Affiliated Hospital of Guangzhou Medical University from January 2021 to May 2022 were included in this randomized controlled trial.They were randomly divided into four groups,with 30 cases in each group.There were 17 males and 13 females in the diclofenac sodium group who were(51.68±5.88)years old,20 males and 10 females in the wrist-ankle acupuncture group who were(49.91±6.71)years old,18 males and 12 females in Evodia group who were(50.28±8.33)years old,and 17 males and 13 females in the wrist-ankle acupuncture combined with Evodia japonica group who were(49.07±8.91)years old.The pain scores calculated by Numerical Rating Scale(NRS),analgesic onset times,analgesic retention times,and adverse reactions were compared between the four groups before and after the treatment.The measurement data were analyzed by ANOV,and the enumeration data chi-square test.Results There was no statistical difference in pain score between the four groups(P=0.305).The wrist-ankle acupuncture combined with Evodia rubra group showed significant effect 5 minutes after the intervention,and the average pain score was 1.12 after 15 minutes.The pain score was 0.68 after 120 minutes,and was more superior than the other groups.The wrist-ankle acupuncture group showed a slow decline during the observative point.After 60 minutes'intervention,the pain score in the Evodia rubra group increased.The diclofenac sodium group did not see significant pain relief in the initial 15 minutes.One case of nausea and vomiting occurred in the diclofenac sodium group.Complications did not occurred in the other three groups.Conclusion Wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing is a safe option in improving pain after PCNL with rapid and long-

关 键 词：腕踝针 吴茱萸热熨 经皮肾镜碎石取石术 疼痛 效果观察 

分 类 号：R277.5[医药卫生—中医学]