电针在取卵术中辅助镇痛作用及对杜冷丁不良反应的影响

Effects of electroacupuncture on supplementary analgesia and improvement of adverse reactions induced by dolantin in oocyte retrieval

目的:观察电针在取卵术中辅助镇痛的效果,并对杜冷丁不良反应的改善作用进行观察,为电针在取卵术中的应用提供科学、有效的临床依据。方法:将134例接受体外受精-胚胎移植(IVF-ET)助孕的门诊患者随机分为针药组和药物组,每组67例。两组患者均于术前30min肌肉注射杜冷丁50mg,针药组注射杜冷丁后给予针刺百会、疼痛穴(右)、三阳络(右)、足三里(右)及耳穴子宫(右耳),得气后在疼痛穴和三阳络行电针刺激,至取卵手术结束。药物组注射杜冷丁30min后进行取卵手术。观察两组患者术中的疼痛等级和疼痛积分,记录术中及术后1h、2h不良反应发生情况。结果:针药组镇痛优良率为97.0%(65/67),药物组为92.5%(62/67),组间镇痛疗效差异有统计学意义(P<0.05);针药组在疼痛等级和疼痛积分方面明显优于药物组(均P<0.05);针药组术中眩晕、出汗、恶心等不良反应发生例数明显少于药物组(均P<0.05);术后1h针药组眩晕、恶心、腹痛例数少于药物组(均P<0.05),术后2h眩晕、恶心、呕吐、腹痛例数少于药物组(均P<0.05)。结论:在B超引导下的经阴道取卵术中,电针在术中辅助镇痛效果好,并在缓解杜冷丁术中及术后不良反应方面有明显的作用。

Objective To observe the effect of electroacupuncture on supplementary analgesia and improvement of adverse reactions induced by dolantin in oocyte retrieval,and to provide scientific and effective evidence for application of electroacupuncture in oocyte retrieval.Methods One hundred and thirty-four patients undergoing in vitro fertilization and embryo transfer（IVF-ET） were randomly divided into an observation group and a control group,67 cases in each group.They were all received intramuscular injection of 50 mg dolantin at 30 min before the operation,and then the observation group was treated with acupuncture at Baihui（GV 20）,pain point（Extra,right）,Sanyangluo（TE 8,right）,Zusanli（ST 36,right） and ear uterus point（right ear）.Pain point and Sanyangluo（TE 8） were received electroacupuncture stimulation after Deqi until the oocyte retrieval operation was finished,and the oocyte retrieval operation was performed in the control group after 30 min of injection of dolantin.The pain grade and score were observed and the adverse reactions during operation or 1 h and 2 h after the operation were recorded.Results The excellent analgesia rate was 97.0%（65/67） in the observation group and 92.5%（62/67） in the control group,with significant difference in the analgesia effect（P0.05）.The pain grade and pain score in the observation group were both superior to those in the control group（both P0.05）.There were fewer cases with the adverse reactions i.e.vertigo,sweating,nausea in the observation group than that in the control group during operation or 1 h and 2 h after the operation（all P0.05）.Conclusion In the oocyte retrieval operation,under the guidance of vaginal B ultrasound,electroacupuncture has a good intraoperative supplementary analgesia effect without intraoperative and postoperative adverse reactions induced by dolantin.