耳穴压豆与针刺疗法联合硬膜外自控镇痛对髋关节置换术术后疼痛的影响

Effect of Auricular Acupoint Pressing with Beans and Acupuncture Combined with Patient-Controlled Epidural Analgesia on Postoperative Pain of Hip Arthroplasty

目的:观察在硬膜外自控镇痛基础上加用耳穴压豆与针刺疗法对髋关节置换术术后疼痛的影响。方法:将96例行人工髋关节置换术的患者随机分为对照组和观察组各48例。2组均于术后予硬膜外患者自控镇痛持续48h,48h后服用塞来昔布胶囊。观察组给予耳穴压豆和针刺疗法。2组均干预7天。记录治疗1、3、5、7天的疼痛视觉模拟评分法(VAS)评分,记录2组患者自控镇痛按压次数和额外镇痛药使用次数,记录治疗1、2、3天的Ramsay镇静评分,记录治疗7天后的匹兹堡睡眠质量指数(PSQI)。结果:治疗1天,2组VAS评分比较,差异无统计学意义(P>0.05);治疗3、5、7天,观察组的VAS评分均低于对照组(P<0.01)。治疗7天,观察组的疼痛程度轻于对照组(P<0.05)。观察组治疗1、2、3天的Ramsay镇静评分均低于对照组(P<0.01)。观察组的患者自控镇痛按压次数和额外镇痛药使用次数均少于对照组(P<0.01)。治疗1周后,观察组的PSQI评分低于对照组,差异有统计学意义(P<0.01)。结论:将耳穴压豆联合针刺疗法应用于人工髋关节置换术术后疼痛患者,能起到镇痛、镇静和改善睡眠质量的作用,并能减少镇痛药物的使用,临床疗效优于单纯术后镇痛治疗。

Objective : To observe the effect of auricular acupoint pressing with beans and acupuncture based on patient-controlled epidural analgesia on postoperative pain of hip arthroplasty. Methods : A total of 96 cases of patients received artificial hip arthroplasty were randomly divided into the control group and the observation group, 48 cases in each group. After operation, both groups received patient controlled analgesia for 48 hours, then took celecoxib capsules. The observation group was additionally treated with auricular acupoint pressing with beans and acupuncture. Both groups were given intervention for seven days. On the 1 st,3 rd,5 thand 7 thday of treatment, the scores of pain in Visual Analogue Scale( VAS) were recorded. The times of patient controlled analgesia pressing and extra analgesia in the two groups were recorded.On the 1 st,2 ndand 3 rdday of treatment, the scores of Ramsay Sedation Scale were recorded. After seven-day treatment, the scores of Pittsburgh Sleep Quality Index( PSQI) were recorded. Results : On the 1 stday of treatment, there was no significant difference being found in the comparison of the scores of VAS in the two groups( P > 0. 05). On the 3 rd,5 thand7 thday of treatment, the scores of VAS in the observation group were lower than those in the control group( P < 0. 01).After seven-day treatment, the degree of pain in the observation group was lower than that in the control group( P < 0. 05).On the 1 st, 2 ndand 3 rdday of treatment, the scores of Ramsay Sedation Scale in the observation group were lower than those in the control group( P < 0. 01). The times of patient controlled analgesia pressing and extra analgesia in the observation group were less than those in the control group( P < 0. 01). After one-week treatment, the score of PSQI in the observation group was lower than that in the control group, the difference being significant( P < 0. 01). Conclusion : The application of auricular acupoint pressing with beans and acupuncture in treating patients with pain after artificial hip arthroplasty can play the role of analgesia, sedation and improvement of sleep quality, and reduce the use of analgesic medicine, whose clinical effect is superior to that of simple postoperative analgesia.