腕踝针用于烧伤换药镇痛的可行性研究

Feasibility of Using Wrist-ankle Acupuncture as an Analgesic Treatment in Dressing Change for Patients with Burns

目的 探讨腕踝针针刺疗法用于烧伤创面换药镇痛的有效性。方法 将 100例Ⅱ度烧伤病人随机分为五组,各20例。观察 1组使用腕踝针后即刻换药,换药结束后5 min取针;观察 2组使用腕踝针后即刻换药,换药结束后病人疼痛消失时取针;观察3组使用并留置腕踝针后12 h换药,换药结束后5 min取针;观察4组使用并留置腕踝针12 h后换药,换药结束后病人疼痛消失时取针;对照组换药过程中未使用腕踝针。比较五组换药前及换药过程中10、20 min,换药后10、20、30 min疼痛评分。结果 疼痛评分换药前五组差异无显著性意义(均P>0.05),换药后观察各组各时段评分显著低于对照组(均P<0.01);观察组间比较,换药后各时段观察4组评分均显著低于其他三组(P<0.05,P<0.01)。结论 腕踝针针刺疗法可有效地缓解烧伤创面换药引起的疼痛,留针时间越长,镇痛效果越好。

Objective To explore the efficacy of wrist-ankle acupuncture as an analgesic treatment in dressing change for patients with burns. Methods One hundred patients with second degree burns were divided into five groups at random, with 20 in each group. In group 1, dressing was changed immediately after the wrist-ankle acupuncture began, and the needles were removed 5 min after the dressing change. In group 2, dressing was changed immediately after the wrist-ankle acupuncture, and the needles were removed until after the pain had disappeared. In group 3, dressing was changed 12 h after the wrist-ankle acupuncture, and the needles were removed 5 min after the acupuncture treatment. In group 4, dressing was changed 12 h after the wrist-ankle acupuncture, and the needles were removed until after the pain had disappeared. In control group, no acupuncture treatment was given during the dressing change. The pain before, during (10 and 20 min) and 10, 20, 30 min after the dressing change was assessed and scored. Results There were no significant differences in pain score among the 5 groups before the dressing change (all P>0. 05). After dressing change, the scores of all acupuncture groups were lower than those of control group (all P<0. 01). Among the acupuncture groups, the scores in the group 4 were significantly lowered than those of the other groups after dressing change (P<0. 05, P<0. 01). Conclusion The wrist-ankle acupuncture is a safe and effective way to alleviate the pain in the dressing change for burns. The longer the needles stay in the acupoint, the better the analgesic effect.