脐针对全膝关节置换术后患者的辅助镇痛效应观察  

Observation on the adjuvant analgesic effect of umbilical acupuncture on patients after total knee arthroplasty

作　　者：刘启明 邵利芳 华慧 穆中杰 黎键 胡柏松 胡淼锋 LIU Qiming;SHAO Lifang;HUA Hui;MU Zhongjie;LI Jian;HU Baisong;HU Miaofeng(Fuyang Orthopaedic Hospital of Traditional Chinese Medicine,Hangzhou,Hangzhou 311400,China)

机构地区：[1]杭州市富阳中医骨伤医院,杭州311400

出　　处：《上海针灸杂志》2024年第2期205-209,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：杭州市卫生科技计划项目(0020190821,B20200150);杭州市医学重点学科建设项目[杭卫发(2021)21号];杭州市富阳区十四五时期“135”优秀中青年人才培养计划[富人社(2022)65号]。

摘　　要：目的 观察脐针对全膝关节置换术后患者的辅助镇痛效应及对患者血清炎性因子水平的影响。方法选择初次行全膝关节置换术的患者70例,采用随机数字表法将患者分为试验组和对照组,每组35例。两组术中均采用硬膜外麻醉,术后均采用常规留置硬膜外镇痛泵镇痛。试验组术后第1天开始每天采用脐针疗法辅助镇痛,对照组术后不做其他镇痛处理。比较两组术后静息和活动状态的疼痛视觉模拟量表(visual analog scale,VAS)评分,比较两组术后第1、7、14天患者血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-6(interleukin-6,IL-6)水平。结果 术后第7、14天,试验组静息和活动状态VAS评分均低于对照组(P<0.05),试验组血清TNF-α和IL-6水平均低于对照组(P<0.05)。结论 在术后常规镇痛治疗基础上联合脐针治疗可有助于缓解全膝关节置换术后疼痛,抑制TNF-α和IL-6的分泌和释放。Objective To observe the adjuvant analgesic effect of umbilical acupuncture on patients after total knee arthroplasty and its influence on serum inflammatory factors.Method A total of 70 patients who underwent total knee arthroplasty for the first time were randomly divided into a trial group and a control group,with 35 cases in each group.Epidural anesthesia was used in both groups during operation,and conventional indwelling epidural analgesia pump was used for postoperative analgesia.The trial group was treated with umbilical acupuncture every day from the first day after operation,while the control group was not treated with other analgesia.The visual analog scale(VAS)scores in resting and active states were compared between the two groups after operation,and the serum tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) levels were compared between the two groups on the 1st,7th and 14th day after operation.Result Compared with the control group,the trial group had significantly lower resting and active VAS scores(P<0.05) and significantly lower serum TNF-α and IL-6 levels(P<0.05) at 7th and 14th day after operation.Conclusion Umbilical acupuncture combined with conventional postoperative analgesia can help to relieve pain after total knee arthroplasty and inhibit the secretion and release of TNF-α and IL-6.

关 键 词：针刺疗法 脐针 针药并用 骨关节炎 膝 疼痛 术后 炎性因子 

分 类 号：R246.2[医药卫生—针灸推拿学]