不同因素取穴法针刺急性疼痛疗效比较研究

A Comparative Study on the Therapeutic Effect of Acupoint Selection in Accordance with Different Factors in the Treatment of Acute Pain

目的采用不同因素取穴法干预急性疼痛,观察即时针刺镇痛效应,优选出最佳取穴方法。方法采用简单随机对照试验设计方法,纳入合格的140例患者,随机分为7组。其中单因素取穴法4组:A组(同侧局部腧穴)20例、B组(同侧远部腧穴)20例、C组(对侧局部腧穴)20例、D组(对侧远部腧穴)20例;双因素取穴法3组:E组(先取同侧局部腧穴、后取同侧远部腧穴)20例、F组(先取同侧远部腧穴、后取同侧局部腧穴)20例、G组(取同侧局部和远部腧穴)20例。参照国际公认的描述与测量疼痛的McGill疼痛询问表,选取其中视觉模拟评分法(VAS)和现有疼痛强度(PPI)制定的疼痛量表为指标,观察即时针刺镇痛效果。结果VAS评分、PPI评分差值和疗效比较显示,单因素取穴组排序为B组>A组>D组>C组;双因素取穴组排序为F组>G组>E组。最佳的2组疗效比较F组优于B组。结论针刺镇痛效应最佳的单因素取穴法为同侧远部腧穴,最佳双因素取穴法为先取同侧远部腧穴、后取同侧局部腧穴;二者比较,后者更佳。

Objective To adopt different factors acupoint selection method for acute pain acupuncture intervention,to observe the immediate analgesic effect of acupuncture,and to optimize the best acupoint selection method.Methods 140 eligible patients were randomly divided into 7 groups by simple randomized controlled trial design.The single factor acupoint selection method was used in four groups:group A(ipsilateral local acupoints)fro 20 cases,group B(ipsilateral far acupoints)for 20 cases,group C(local acupoints on the opposite side)for 20 cases,and group D(far acupoints on the opposite side)for 20 cases.Two-factor acupoint selection method:group E(local acupoints on the same side first,remote acupoints on the same side later)for 20 cases,group F(local acupoints on the same side first,local acupoints on the same side later)for 20 cases,group G(local acupoints on the same side and remote acupoints at the same time)for 20 cases.Referring to the internationally recognized McGill pain inquiry table that describes and measures pain,visual analogue scale(VAS)and the existing pain intensity scale(PPI)were selected as indicators to observe the immediate analgesic effect of acupuncture.Results VAS score,PPI score difference and efficacy comparison showed that the single-factor acupoint selection group was ranked as B group,A group,D group,C group.The two-factor acupoint selection group was ranked as F group,group G group,group E.Compared with group B,the best two groups had better efficacy.Conclusion The best single factor acupoint selection method for acupuncture analgesic effect is ipsilateral distal acupoints,and the best double factor acupoint selection method is ipsilateral distal acupoints first,and ipsilateral local acupoints later.Of the two,the latter is better.