不同留针时间干预急性疼痛临床观察

Observation on clinical efficacy of acute pain treated with the intervention of different time of needle retention

目的:对针刺后不同留针时间治疗急性疼痛的疗效进行对比观察,为针刺镇痛留针时间的优选提供科学依据。方法:将80例急性疼痛患者(急性腰扭伤、落枕)随机分为4组,分别于针刺得气后留针20min、30min、45min、60min。急性腰扭伤取阿是穴、后溪、委中穴为主,落枕取阿是穴、风池、列缺穴为主。以国际公认的描述及测量疼痛的McGill疼痛询问表为观察指标,记录观察对象治疗前后及3个月后疼痛症状的各项评分变化,对不同留针时间干预方法的即时镇痛疗效及3个月后随访的远期疗效进行对比评价。结果:4组治疗后视觉模拟评分(VAS)和现有疼痛强度(PPI)评分均显著改善(均P<0.01),且45min组优于其他3组(VAS:2.90±0.87vs 5.52±1.01,4.45±0.81,5.95±1.07;PPI:1.40±0.21vs 2.26±0.54,2.21±0.43,2.28±0.74,均P<0.01)。45min组即时镇痛总有效率为95.0%(19/20),亦优于其他3组。结论:对急性疼痛针刺镇痛最佳疗效的留针时间为45min。

Objective To compare the efficacy on acute pain treated under the different time of needle retention so as to provide the scientific evidence for the optimization of needle retention time for acupuncture analgesia. Methods Eighty cases of acute pain （acute lumbar sprain, stiffness of neck） were randomized into 4 groups. Acu- puncture was applied to all the patients. After the arrival of needling sensation, the needles were retained for 20 min, 30 rain, 45 rain and 60 min in different groups separately. For acute lumbar sprain, Ashi （Extra）, Houxi （SI 3） and Weizhong （BL 40） were the main points. For stiffness of neck, Ashi （Extra）, Fengchi （GB 20） and Lieque （LU 7） were the main points. McGill pain scale, the internationally recognized pain description and measurement was adopted to observe the indexes and record the score changes of each item of pain symptoms before and 3 months after treatment. The immediate analgesic efficacy under different time of needle retention and the longterm efficacy in follow-up visit 3 months after treatment were compared and assessed among the groups. Results The scores of visual analogue scale （VAS） and present pain intensity （PPI） after treatment were all improved sig- nificantly as compared with those before treatment in the 4 groups （all P〈0.01）, and the result in the 45 min group was superior to the other 3 groups （VAS： 2.90±0.87 vs 5.52±1.01, 4.45±0. 81, 5.95±1.07; PPI： 1. 40±0.21 vs 2.26±0.54, 2. 21±0.43, 2. 28±0. 74, all P〈0.01）. The total effective rate of the immediate analgesia was 95.0% （19/20） in the 45 min group, which was better than that in each of the other 3 groups. Conclusion The 45 rain of needle retention achieves the best efficacy of acupuncture analgesia in treatment of acute pain.