针刺配合穴位敷贴对减轻胸部手术后创口疼痛的临床评价

Clinical Evaluation of Acupuncture Combined with Acupoint Application on Wound Pain after Thoracic Surgery

目的:探讨针刺配合穴位敷贴对胸部手术后急性创口疼痛的缓解作用。方法:选择符合观察标准的开胸手术或胸腔镜手术患者,将患者随机分观察组和对照组。所有患者均使用PCA自控镇痛法止痛;观察组从术后4 h起行针刺治疗,治疗时间点分别为术后4、8、24、48 h,针刺间隔期使用穴位敷贴。采用直观模拟量表法(VAS)和简化的Mc Gill疼痛问卷(SF-MPQ)对患者进行疼痛评估;并于术后4 h及48 h检测患者外周血中儿茶酚胺(多巴胺、去甲肾上腺素、肾上腺素)含量。结果:VAS评分、SF-MPQ评估显示,观察组和对照组治疗后均较治疗前显著降低(P<0.05),且观察组的下降程度优于对照组(P<0.05);观察组的有效率均优于对照组(P<0.05)。肾上腺素含量治疗前后及组间差异均有统计学意义(P<0.05);多巴胺含量观察组与对照组治疗前后差异有统计学意义(P<0.05),但组间无显著性差异(P>0.05);去甲肾上腺素含量观察组和对照组治疗前后及组间均无显著性差异(P>0.05)。结论:针刺配合穴位敷贴治疗对患者术后的创口疼痛有明显的改善作用。

Objective： To investigate the relieving effect of acupuncture combined with acupoint application on acute wound pain after thoracic surgery. Methods： Patients of thoracic surgery or thoracoscopic surgery who meet the observation criteria were recruited and randomly divided into the observation group and control group. All patients were treated with PCA self controlled analgesia to relieve pain. The patients in the observation group were treated with acupuncture at postoperative 4,8,24 and 48 h. During the interval of acupuncture,acupoint application was conducted. Pain of patients was evaluated by the Visual Analogue Scale（ VAS） and the Simplified Mc Gill Pain Questionnaire（ SF-MPQ）. And the contents of blood catecholamine（ including dopamine,norepinephrine and epinephrine） were detected at postoperative 4 h and 8h. Results：Compared with the treatment before,the VAS and SF-MPQ score in the two groups were both significantly decreased after treatment（ P〈0. 05）,and the descent degree of the observation group was better than that of the control group（ P〈0. 05）. The effective rate of the observation group was better than that of the control group（ P〈0. 05）. Comparison of the treatment before and after,as well as comparison between the two groups,the difference on the content of epinephrine was statistically significant（ P〈0. 05）,but the difference on the content of adrenaline was not statistically significant（ P〉0. 05）. Comparison of the treatment before and after,the difference on the content of dopamine was statistically significant（ P〈0. 05）,while the comparison between the two groups,the difference on the content of dopamine was not statistically significant（ P〉0. 05）Conclusion： Acupuncture combined with acupoint sticking therapy show obvious effects on improving the postoperative wound pain.