经皮穴位电刺激对全膝置换术后患者辅助镇痛疗效及血浆β-内啡肽的影响  

Effects of Transcutaneous Electrical Acupoint Stimulation on Adjuvant Analgesia and Plasmaβ-endorphin in Patients after Total Knee Arthroplasty

作　　者：白天宇 邱佳明 李紫阁 危一飞 温冠楠 梁佩文 程桯[1,2] BAI Tianyu;QIU Jiaming;LI Zige;WEI Yifei;WEN Guannan;LIANG Peiwen;CHENG Ting(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Key Laboratory of Traditional Chinese Medicine Bone-setting Technology,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中医正骨技术北京市重点实验室,北京100102

出　　处：《中国中医药信息杂志》2023年第5期141-145,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：首都卫生发展科研专项(首发2022-2-4162);中国中医科学院育苗基金培育专项(ZZ11-078)。

摘　　要：目的探究经皮穴位电刺激联合常规镇痛方案对全膝置换术后的镇痛疗效及血浆β-内啡肽(β-EP)含量的影响。方法采用随机数字表法将144例行全膝置换术的患者随机分为试验组与对照组各72例,对照组应用术后常规镇痛方案,试验组应用经皮穴位电刺激联合术后常规镇痛方案,记录并分析2组患者术前及术后不同时点的血浆β-EP含量、静息状态下患膝疼痛视觉模拟评分法(VAS)评分、美国特种外科医院膝关节功能评分量表(HSS)评分、患膝痛阈值、阿片类药物不良反应。结果试验组脱落1例,对照组脱落3例。与本组术前比较,2组患者术后3 d血浆β-EP含量、术后7 d及术后14 d HSS评分、术后7 d痛阈值均升高,2组患者术后7 d及试验组术后3 d VAS评分均降低(P<0.05)。2组同期比较,试验组患者术后3 d血浆β-EP水平高于对照组(P<0.05);试验组患者术后3 d、术后7 d VAS评分均低于对照组(P<0.05);试验组患者术后7 d、术后14 d HSS评分均高于对照组(P<0.05);试验组患者术后3 d、术后7 d患膝痛阈值均高于对照组(P<0.05);试验组患者术后阿片类药物不良反应少于对照组(P<0.05)。结论经皮穴位电刺激配合常规镇痛方案可减轻全膝置换术后患者疼痛,促进血浆β-EP分泌,加速关节功能恢复,减少术后相关药物不良反应。Objective To investigate the effect of transcutaneous electrical acupoint stimulation combined with routine analgesia on the analgesic efficacy and plasmaβ-endorphin(β-EP)content after total knee arthroplasty.Methods Totolly 144 patients who underwent this procedure were randomly divided into experimental group and control group with 72 cases in each group.The control group received postoperative routine analgesia,and the experimental group received postoperative transcutaneous electrical acupoint stimulation combined with routine analgesia.The plasmaβ-EP content,visual analog scale(VAS)score at resting state,American Hospital for Special Surgery Knee Function Scale(HSS)score,the knee pain threshold,and adverse reactions to opioids were recorded and analyzed in the two groups before and after surgery at different time points.Results One case was shed in experimental group and 3 cases in control group.Compared with before surgery,plasmaβ-EP level at 3 d after surgery,HSS score at 7 d and 14 d after surgery and pain threshold at 7 d after surgery were increased in two groups,and VAS score at 7 d after surgery in two groups and 3 d after surgery in experimental group were decreased(P<0.05).Compared with the same period,the plasmaβ-EP content of experimental group was higher than that of the control group at 3 d after surgery(P<0.05),the VAS scores at 3 d and 7 d after surgery were lower than that of the control group(P<0.05),the HSS score was higher than that of the control group at 7 d and 14 d after surgery(P<0.05),the knee pain threshold was higher than that of the control group at 3 d and 7 d after surgery(P<0.05).The occurrence of postoperative opioid-related drug reactions in experimental group was less than that in control group(P<0.05).Conclusion Transcutaneous electrical acupoint stimulation combined with routine postoperative analgesia can alleviate postoperative pain in patients after total knee arthroplasty,promote plasmaβ-EP secretion,accelerate the recovery of joint function,and reduce postoperat

关 键 词：全膝置换术 术后疼痛 经皮穴位电刺激 Β-内啡肽 功能康复 

分 类 号：R274.94[医药卫生—中西医结合]