中药穴位贴敷防治骨科全麻术后恶心呕吐的临床观察

Clinical observation of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia

目的:探讨采用中药穴位贴敷防治脊柱术后患者恶心呕吐的临床疗效。方法:自2018年1月至2019年12月,将符合纳入标准的168例择期脊柱手术患者,按中央随机双盲法分为两组,每组84例。对照组男39例,女45例;年龄30~65(53.83±9.17)岁;根据美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级:Ⅰ级37例,Ⅱ级47例。试验组男39例,女45例;年龄30~65(54.08±9.00)岁;ASA分级:Ⅰ级32例,Ⅱ级52例。两组均于麻醉诱导前给予穴位贴敷,贴敷剂贴于患者的中脘穴、双侧内关穴上持续6 h;24 h后更换,连续贴敷2 d。试验组贴敷剂的药物处方为姜半夏、生姜及丁香;对照组贴敷剂与试验组药物贴在外观及气味上做到最大程度的一致性,成分为面粉及具有10%试验药物浓度的辅料。经第3方采用R3.6.1 Rstudio软件统计分析,比较两组患者术后24 h、24~48 h恶心呕吐发生例数和恶心呕吐程度的视觉模拟评分(visual analogue scale,VAS);比较术前、术后24和48 h的SF-12简易生活质量评分。结果:两组患者术后24 h内恶心呕吐发生例数及恶心呕吐程度的VAS评分比较差异无统计学意义(P>0.05);两组患者术后24~48 h恶心呕吐发生例数及恶心呕吐程度的VAS评分比较差异无统计学意义(P>0.05)。两组患者术前、术后24和48 h的SF-12简易生活质量评分比较差异无统计学意义(P>0.05)。结论:中药穴位贴敷防治术后患者恶心呕吐的疗效不明显。

Objective:To explore clinical effect of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia.Methods:From January 2018 to December 2019,168 patients who met inclusion criteria and were underwent selective spine surgery,were double-blind divided into two groups according to central random system,84 patients in each group.In control group,there were 39 males and 45 females aged from 30 to 65 years old with an average of(53.83±9.17)years old,37 patients were classified to typeⅠand 47 patients were typeⅡaccording to American Society of Anesthesiologists(ASA)grading.In experiment group,there were 39 males and 45 females aged from 30 to 65 years old with an average of(54.08±9.00)years old;32 patients were classified to typeⅠand 52 patients were typeⅡaccording to ASA grading.Both of two groups were obtained acupoint application before anesthesia induction,and acupoint application were put on Zhongwan(CV 12)and bilateral Neiguan(PC 6)for 6 h,changed after 24 h,last for 2 d.The drug prescription of plasters in experimental group was consist of Rhizome Pinelliae Preparata,Ginger and Clove.The plasters in control group was consistent with drug plasters in experimental group in appearance and smell to the greatest extent.The ingredients were flour and excipients with 10%of experimental drug concentration.Incidence of nausea vomiting,visual analogue scale(VAS)of narusea degree at 24 h and 24 to 48 h after operation between two groups were compared,SF-12 simple quality of life score before operation,24 and 48 h after operation were also compared by using R3.6.1 Rstudio soft-ware by the third-party.Results:There were no statistical differences in incidence of nausea vomiting,VAS of narusea degree at 24 h after operation(P>0.05),while there were no differences in incidence of nausea vomiting,VAS of narusea degree at 24 to 48 h after operation(P>0.05).There were no statistical differences in SF-12 before operation,24 and 48 h after opertaion(P>0.05).Conclusion:The curative effect of acupoint application of traditional Chinese medicine on the prevention and treatment of postoperative nausea and vomiting is not obvious.