耳穴压籽联合经皮穴位电刺激对老年膝关节置换术后急性疼痛的作用

Effect of auricular seed pressing combined with transcutaneous electrical acupoint stimulation on acute pain in elderly patients after total knee arthroplasty

目的探讨耳穴压籽联合经皮穴位电刺激对老年膝关节置换术后急性疼痛的作用效果。方法将2019年12月至2021年12月在南通市中医院骨科接受膝关节置换术的112例老年患者纳入本研究,按随机数表法分为对照组和研究组,均为56例。2组患者均接受了膝关节置换术,对照组术后接受常规镇痛方案,研究组在对照组基础上采用耳穴压籽联合经皮穴位电刺激。比较2组术后恢复指标、疼痛程度、疼痛阈值、膝关节功能及活动度、免疫功能、不良反应等指标。结果研究组首次下床活动时间、术后镇痛药物使用量、引流管留置时间、术后住院天数均低于对照组(P<0.05)。研究组术后1 d、3 d、5 d VAS评分均比对照组低(P<0.05)。研究组术后3 d、5 d、7 d VAS评分均比对照组低(P<0.05)。术后7 d研究组HSS评分、ROM均高于对照组(P<0.05)。术后7d研究组CD_(3)^(+)、CD_(4)^(+)均比对照组高,CD8+比对照组低(P<0.05)。研究组不良反应总发生率为8.93%,低于对照组23.21%(P<0.05)。结论耳穴压籽联合经皮穴位电刺激应用于接受膝关节置换术的老年患者可有效提高术后疼痛阈值,缓解疼痛,并可改善膝关节功能和免疫功能,减少术后不良反应。

Objective To explore the effect of auricular seed pressing combined with percutaneous electrical acupoint stimulation on acute pain in elderly patients after knee arthroplasty.Methods One hundred and twelve elderly patients who underwent knee arthroplasty at our hospital from December 2019 to December 2021 were included in this study.They were randomly divided into either a control group or a study group,with 56 cases in each group.Both groups of patients received knee arthroplasty and routine analgesia after operation,and the study group additionally underwent auricular seed pressing combined with percutaneous electrical acupoint stimulation.The indexes of postoperative recovery,degree of pain,pain threshold,knee function and range of motion,immune function,and adverse reactions were compared between the two groups.Results The time to first ambulation,the dosage of postoperative analgesic drug,the time of indwelling drainage tube,and the days of hospitalization in the study group were all lower than those in the control group(P<0.05).The VAS scores of the study group were lower than those of the control group at 1,3,and 5 days postoperatively(P<0.05).The VAS scores of the study group were lower than those of the control group at 3,5,and 7 days postoperatively(P<0.05).HSS score and ROM in study group were higher than those in the control group 7 days after operation(P<0.05).The percentages of CD_(3)^(+)T cells and CD_(4)^(+)T cells in the study group were higher than those in the control group,and the percentage of CD8+T cells was lower than that in the control group on the 7th day after operation(P<0.05).The total incidence of adverse drug reactions was 8.93%,lower than that in the control group(23.21%;P<0.05).Conclusion Auricular seed pressing combined with transcutaneous electrical acupoint stimulation in elderly patients undergoing total knee arthroplasty can effectively increase postoperative pain threshold,alleviate pain,improve knee function and immune function,and reduce the adverse reaction after operation.