耳穴贴压在肩袖损伤住院患者关节镜术后早期疼痛管理中的应用

Application of auricular acupressure therapy in the early pain management of hospitalized patients after shoulder arthroscopic rotator cuff repair

目的探讨耳穴贴压在肩袖损伤住院患者关节镜术后早期疼痛管理中的应用效果。方法选取2018年1月至2019年10月在北京大学人民医院创伤骨科行肩关节镜治疗的肩袖损伤患者共84例,对照组42例采取常规镇痛措施;观察组42例在常规镇痛的基础上于入院后给予患者进行耳穴贴压。采用视觉模拟评分法(visual analogue scale,VAS)评估两组患者术后24~72 h的疼痛改善情况。结果观察组术后48 h的静息VAS评分和活动VAS评分较术后24 h的VAS评分改善均优于对照组,差异均有统计学意义(P<0.05);观察组术后72 h的静息VAS评分和活动VAS评分较术后24 h的VAS评分改善均优于对照组,差异均有统计学意义(P<0.05)。结论中医耳穴贴压能有效辅助减轻肩袖损伤住院患者关节镜术后的早期疼痛,操作简便,值得在临床推广。

Background Rotator cuff injury is a common cause of shoulder pain and dysfunction.Shoulder arthroscopic technique has the advantages of minimal trauma,accurate operation and direct vision,which has been widely used in the treatment of rotator cuff injury.Postoperative pain is a common problem,and the application of multiple analgesic methods produces synergistic analgesic effect,which reduces the doses of each drug.However,some patients still have serious adverse reactions to the analgesic drugs in clinical practice,and they have to stop the use of analgesic drugs and suffer from inadequate analgesic effect.In China,the earliest application of auricular acupressure therapy in the diagnosis and treatment of diseases can be traced back to over 2000 years ago.According to the records of Internal Canon of Medicine and Canon On Eighty-One Difficult Issues in traditional Chinese medicine,the ear point stimulation could produce a certain regulating effect on the human body through the meridians ascending to the ear.Relevant studies have shown that the auricular acupressure therapy for analgesia has the advantages of significant efficacy and less side effects,which can relieve perioperative insomnia,nausea,vomiting,constipation and other common symptoms,and can also be used as an auxiliary treatment for common orthopedic diseases such as lumbar disc herniation and arthritis.However,there are few studies on the analgesic effect of auricular acupressure therapy on patients with rotator cuff injury after arthroscopic surgery.Objective To investigate the application effect of auricular acupressure therapy on early pain management after arthroscopic surgery in patients with rotator cuff injury.Methods From January 2018 to October 2019,a total of 84 patients who underwent arthroscopic rotator cuff repair were selected as the research objects,and randomly divided into two groups.The control group included 42 cases and received routine analgesic therapy.In the control group,42 patients were given auricular acupressure therapy on the basis of routine analgesia.The visual analogue score(VAS)was used to evaluate the improvement of pain 24 to 72 hours after surgery in both groups.Results The VAS scores during rest and movement at 48 h after surgery in the observation group were better than those of the control group at 24 h after surgery,and the differences were statistically significant(P<0.05).The VAS scores during rest and movement at 72 h after surgery in the observation group were better than those of the control group at 24 h after surgery,and the differences were statistically significant(P<0.05).Conclusions The auricular acupressure therapy of traditional Chinese medicine can effectively relieve the early pain after arthroscopic surgery in hospitalized patients with rotator cuff injury,and it is easy to operate and worth promoting in clinic.