董氏奇穴联合颊针对全膝关节置换围术期多模式镇痛的临床研究  

Clinical Effect of Dong's Extra-Points Combined with Buccal Acupunctureon Perioperative Multi-Mode Analgesia of TKA

作　　者：凌泽权 李阳 何勇[1] 王兴龙[1] LING Zequan;LI Yang;HE Yong;WANG Xinglong(Shandong Linyi Hospital of Traditional Chinese Medicine,Linyi 276000,China;Shandong Medical College,Linyi 276000,China)

机构地区：[1]山东省临沂市中医医院,山东临沂276000 [2]山东医学高等专科学校,山东临沂276000

出　　处：《针灸临床杂志》2023年第9期29-33,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：临沂市重点研发计划(医学类);编号:2022YX0141。

摘　　要：目的:观察董氏奇穴联合颊针在全膝关节置换(TKA)围术期多模式镇痛中的临床疗效。方法:将60例诊断为膝骨性关节炎患者随机分为对照组和研究组,每组各30例。对照组采用快速康复管理的多模式镇痛方式:股神经麻醉阻滞+静脉自控镇痛泵(PCIA)+术前2 h、术后6 h分别给予0.1 g艾瑞昔布,服用7 d, 2次/d, 0.1 g/次;研究组在对照组基础上应用董氏奇穴联合颊针替代艾瑞昔布治疗,术前2 h、术后6 h应用董氏奇穴联合颊针,针刺7 d, 1次/d, 1次40 min。通过观察比较两组患者的疼痛视觉模拟(VAS)评分、PCIA按压次数、膝关节美国特种外科医院(HSS)评分和术后不良反应来评价疗效。结果:研究组术后3 d、5 d与10 d的VAS评分低于对照组,差异具有统计学意义(P<0.05)。研究组术后7 d、14 d的HSS评分优于对照组,差异具有统计学意义(P<0.05)。研究组在术后48 h内的PCIA按压次数、术后胃痛恶心呕吐等胃肠道不良反应发生次数低于对照组,差异具有统计学意义(P<0.05)。结论:董氏奇穴联合颊针对TKA术后患者的早期镇痛效果显著,可更快改善患者关节功能活动,能够减少药物使用,降低不良反应的发生率。Objective:To observe the clinical effect of Dong’s extra-points combined with buccal acupuncture on perioperative multi-mode analgesia of total knee replacement(TKA).Methods:60 patients diagnosed with knee osteoarthritis(KOA)were randomly divided into the control group and the study group,with 30 patients in each group.The control group was given multi-mode analgesia with rapid rehabilitation management,i.e.femoral nerve anesthesia block,self-controlled intravenous analgesia pump(PCIA),and 0.1 g Imericoxib(2 h before surgery and 6 h after surgery)respectively for 7 d,twice a day,0.1 g each time;in the study group,Dong’s extra-points combined with buccal acupuncture was used instead of Imercioxib therapy,2 h before surgery and 6 h after surgery for 7 d,once a day for 40 min.Visual analog pain(VAS)score,PCIA compression times,HSS score and postoperative adverse reactions were observed and compared between the two groups to evaluate efficacy.Results:VAS scores of the study group were lower than those of the control group at 3 d,5 d and 10 d after surgery(P<0.05).The HSS score of the study group was better than that of the control group at 7 d and 14 d after surgery(P<0.05).The frequency of PCIA compression,postoperative stomachache,nausea and vomiting and other gastrointestinal adverse reactions were lower in the study group than those in the control group(P<0.05).Conclusion:Dong’s extra-points combined with Buccal acupuncture has a significant early analgesic effect on patients after TKA surgery,which can improve joint functional activities faster,reduce drug use and reduce the incidence of adverse reactions.

关 键 词：董氏奇穴 颊针 全膝关节置换 多模式镇痛 

分 类 号：R246.2[医药卫生—针灸推拿学]