耳穴压丸法辅助镇痛对原发性全膝关节置换术后下肢疼痛和膝关节功能的影响  

Observation on the Clinical Effect of Ear Acupoint Pressing Pill Assisted Analgesia on Lower Extremity Pain and Knee Joint Function After Primary Total Knee Arthroplasty

作　　者：钟伟华[1] 苟凌云 廖明军 朱勇 马开好[1] 朱永林 廖小林[1] 张耀利 Zhong Weihua;Gou Lingyun;Liao Mingjun;Zhu Yong;Ma Kaihao;Zhu Yonglin;Liao Xiaolin;Zhang Yaoli(The Second Ward of the Department of Trauma and Joint Orthopedics,Liuzhou Hospital of Traditional Chinese Medicine/The Third Hospital Affiliated to Guangxi University of Chinese Medicine,Liuzhou 545001,China)

机构地区：[1]柳州市中医医院/广西中医药大学第三附属医院创伤关节骨科二病区,广西柳州545001

出　　处：《亚太传统医药》2023年第3期88-93,共6页Asia-Pacific Traditional Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹课题(Z20170807)。

摘　　要：目的:比较耳穴压丸法与假耳压疗法辅助镇痛对原发性膝骨关节炎(KOA)行全膝关节置换术(TKA)后下肢疼痛和膝关节功能的影响。方法:前瞻性连续纳入我院TKA手术的原发性KOA患者100例,采用随机数字表法分为试验组与对照组,两组患者术后临床镇痛方案相同,试验组在此基础上联合耳穴压丸法以辅助镇痛,而对照组是联合假耳压疗法辅助镇痛。比较两组患者术前和术后3天血红蛋白量、术中出血量与术后引流量、术后主动屈膝90°所需的时间(d)、术后屈膝45°与静息状况下各时间点疼痛视觉模拟量表评分(VAS)、术前和术后各时间点美国特种外科医院评分(HSS)。结果:两组患者术前VAS评分、术前血红蛋白量、术中出血量和术前膝关节功能评分(HSS)无统计学差异(P>0.05);试验组术后48 h、72 h的下肢疼痛评分无论在静息状态下还是在屈膝45°的情况下VAS评分均显著低于对照组(P<0.01);试验组术后血红蛋白量(72 h)明显高于对照组(P<0.01);试验组术后第1周、1个月和3个月的HSS评分均比对照组显著增高(P<0.01);试验组术后引流量、术后主动屈膝90°所需的时间(d)明显少于对照组(P<0.01)。结论:耳穴压丸法可以辅助镇痛,有利于促进TKA手术患者的术后快速功能康复,有效缓解术后下肢的疼痛不适感,加速患肢屈膝功能的恢复,该技术适宜在基层推广应用。Objective: To compare the clinical efficacy of ear acupoint pressing pill test group and control group on lower extremity pain and knee joint function after total knee arthroplasty(TKA) for primary knee osteoarthritis(KOA). Methods:100 patients with primary KOA who underwent TKA surgery in our hospital were prospectively and consecutively included and were divided into the experimental group and the control group by random number table. Pills were used to assist analgesia, while the control group was combined with sham ear pressure therapy to assist analgesia. The amount of hemoglobin, intraoperative blood loss and postoperative drainage, postoperative time required for 90° active knee flexion(d),postoperative 45° knee flexion and each time at rest were compared between the two groups of patients before and 3 days after operation Point pain visual analog scale score(Visual Analogue Scale, VAS),preoperative and postoperative time points US Hospital for Special Surgery score(HSS). Results:There was no significant difference in preoperative VAS score, preoperative hemoglobin, intraoperative blood loss and preoperative knee function score(HSS) between the two groups(P>0.05). The VAS score was significantly lower than that of the control group in the resting state or at 45° of flexion of the knee(P<0.01);the postoperative hemoglobin level(72h) in the experimental group was significantly higher than that in the control group(P<0.01);The HSS scores at the 1st week, 1st and 3rd month were significantly higher than those of the control group(P<0.01);the postoperative drainage volume and the time required for 90° of active knee flexion(d) in the experimental group were significantly shorter than those in the control group(P<0.01). (P<0.01). Conclusion:Auricular acupoint pressing pills can assist in analgesia, which is conducive to promoting the rapid postoperative functional recovery of TKA patients, effectively relieving the pain and discomfort of the lower limbs after surgery, and accelerating the recovery of the kne

关 键 词：耳穴压丸法 全膝关节置换术 假耳压疗法 辅助镇痛 膝关节功能 临床观察 

分 类 号：R274[医药卫生—中医骨伤科学]