脚踝针结合择时耳穴压丸用于胸外科术后镇痛效果的研究  

Study on Analgesic Effect of Ankle Acupuncture Combined with Timing Ear-point Pressure Pill after Thoracic Surgery

作　　者：魏会聪 赵琴 李婵 赵亮 温梦莎 WEI Huicong;ZHAO Qin;LI Chan;ZHAO Liang;WEN Mengsha(The Third Department of Thoracic Surgery,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]河北省中医院外三科,石家庄050000

出　　处：《临床误诊误治》2024年第1期118-123,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省中医药管理局科研计划项目(2020114)。

摘　　要：目的探讨脚踝针结合择时耳穴压丸用于胸外科术后镇痛效果。方法前瞻性选取2020年1月—2022年12月收治的胸外科术后患者130例,采用随机数字表法分为3组,A组44例采取脚踝针结合择时耳穴压丸,B组43例采取脚踝针,C组43例采取择时耳穴压丸。比较3组视觉模拟评分法(VAS)评分、静脉自控镇痛(PCIA)给药次数、疼痛介质[5-羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))、β-内啡肽(β-EP)]、呼吸功能指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)]、匹兹堡睡眠质量指数(PSQI)评分、医院焦虑抑郁量表(HAD)评分、不良事件发生率及舒适度。结果术后3、7 d,A组静息和活动状态VAS评分、PaCO_(2)及血清5-HT、PGE_(2)水平低于B组、C组,PaO_(2)、OI、β-EP高于B组、C组(P<0.05)。术后7 d,A组PSQI、HAD评分均低于B组、C组(P<0.05)。A组舒适度优于B组、C组,PCIA给药次数少于B组、C组(P<0.05)。B组与C组舒适度和PCIA给药次数比较差异均无统计学意义(P>0.05)。3组不良事件发生率比较差异无统计学意义(P>0.05)。结论脚踝针结合择时耳穴压丸用于胸外科术后镇痛效果确切,可减轻负面情绪,提高舒适度,改善睡眠及呼吸功能,可能与调节疼痛介质有关。Objective To explore the analgesic effect of ankle acupuncture combined with timing ear acupoint pressing pills for postoperative thoracic surgery.Methods A prospective selection of 130 patients receiving thoracic surgery admitted from January 2020 to December 2022 was conducted.They were divided into three groups using a random number table method.Group A consisted of 44 patients who received ankle acupuncture combined with timing ear acupoint pressing pills,group B consisted of 43 patients who received ankle acupuncture,and group C consisted of 43 patients who received timing ear acupoint pressing pills.Visual analogue scale(VAS)scores,number of patient-controlled intravenous analgesia(PCIA)compression,and pain mediators[5-hydroxytryptamine(5-HT),prostaglandin E_(2)(PGE_(2)),β-Endorphin(β-EP)],respiratory function indicators[arterial oxygen pressure(PaO_(2)),arterial carbon dioxide pressure(PaCO_(2)),oxygenation index(OI)],Pittsburgh Sleep Quality Index(PSQI)score,Hospital Anxiety and Depression Scale(HAD)score,incidence of adverse events,and comfort level were compared among the three groups.Results At 3 and 7 d after surgery,VAS scores at rest and movement,PaCO_(2),serum 5-HT,and PGE_(2) levels were lower in group A than in group B and group C,while PaO_(2),OI,andβ-EP were higher than those of group B and group C(P<0.05).At 7 d after surgery,the PSQI and HAD scores of group A were lower than those of group B and group C(P<0.05).The comfort level of group A was better than that of group B and group C,while the number of PCIA administration was less than that of group B and group C(P<0.05).There was no statistically significant difference in comfort level and the number of PCIA administration between group B and group C(P>0.05).There was no statistically significant difference in the incidence of adverse events among the three groups(P>0.05).Conclusion The combination of ankle acupuncture and timing ear acupoint pressure pills has a definite analgesic effect after thoracic surgery.It can alleviate negative e

关 键 词：胸外科 镇痛 耳穴压丸 脚踝针 前列腺素E_(2) 氧合指数 匹兹堡睡眠质量指数 医院焦虑抑郁量表 

分 类 号：R614[医药卫生—麻醉学] R655[医药卫生—外科学]