经皮穴位电刺激在混合痔术后镇痛疗效的临床观察

Clinical Observation on Analgesic Effect of Percutaneous Electrical Stimulation on Postoperative Mixed Hemorrhoids

目的探讨经皮穴位电刺激在混合痔术后的镇痛疗效。方法选取2017年11月至2018年11月上海中医药大学附属曙光医院柏氏肛肠科收治的混合痔患者90例,依据随机数字法分为对照组和研究组,各45例。所有患者均采用外剥内扎手术治疗,术后对照组采用口服洛索洛芬钠药物镇痛,研究组采用经皮穴位电刺激镇痛。比较两组术后镇痛效果、手术前后视觉模拟评分(VAS)以及术后镇痛不良反应发生率。结果研究组术后镇痛总有效率高于对照组[100. 0%(45/45)比91. 1%(41/45)](P <0. 05)。两组术后1 d、3 d VAS评分较术前降低,研究组术后1 d、3 d VAS均低于对照组,两组间、时点间、组间和时点间交互作用差异有统计学意义(P <0. 01);研究组首次疼痛时间晚于对照组[(8. 8±1. 6) h比(6. 7±1. 4) h](P <0. 05),疼痛消失时间早于对照组[(145. 6±6. 1) h比(184. 8±5. 0) h](P <0. 05);研究组术后头痛头晕、恶心呕吐、肛门肿胀、尿潴留的发生率均低于对照组(P <0. 05)。结论经皮穴位电刺激在治疗混合痔患者术后疼痛方面具有较好的疗效,可减轻患者术后疼痛,减少患者术后镇痛药物不良反应的发生,是混合痔术后镇痛的有效方法。

Objective To investigate the clinical effect of acupoint electrical stimulation on postoperative analgesia of mixed hemorrhoids. Methods From Nov. 2017 to Nov. 2018,90 patients with mixed hemorrhoids treated in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were included. According to the random number method,they were divided into a control group and a study group,each with 45 cases. All patients were treated by external stripping and internal ligation. After surgery,the control group was treated by oral loxoprofen sodium,and the study group was treated by transcutaneous acupoint electric stimulation. The effects of postoperative analgesia,the visual analogue score( VAS) and incidence of adverse reactions were compared between the two groups. Results The total effective rate of postoperative analgesia in the study group was higher than that in the control group[100. 0%( 45/45) vs 91. 1%( 41/45) ]( P < 0. 05). The VAS scores of the two groups on the 1st and 3rd day after operation were lower than before operation,and the VAS score of the study group was lower than that of the control group on the 1st and 3rd day after operation. There was statistically significant difference between the two groups,time points,and interactions of groups and time points( P <0. 01);the first time of pain in the study group was later than that in the control group[( 8. 8 ± 1. 6) h vs( 6. 7 ± 1. 4) h]( P < 0. 05),and the time of pain disappearance was earlier than that in the control group[( 145. 6 ± 6. 1) h vs( 184. 8 ±5. 0) h]( P < 0. 05);the incidences of adverse reactions such as headache,dizziness,nausea and vomiting,anal swelling and urinary retention in the study group were lower than those in the control group( P < 0. 05). Conclusion Transcutaneous acupoint electrical stimulation has a good effect in the treatment of postoperative pain in patients with mixed hemorrhoids. It can reduce the postoperative pain of patients and the occurrence of adverse reactions of analgesic drugs,therefore is an effective method of for postoperative analgesia after surgery on mixed hemorrhoids.