耳穴压豆联合中医定向透药对全膝关节置换术后患者早期疼痛的干预研究

Intervention study of ear point pressing beans combined with directional Chinese medicine penetration on early pain after total knee arthroplasty

目的探究耳穴压豆联合中医定向透药对全膝关节置换术后早期疼痛、膝关节活动度的影响及疗效情况。方法选取2017年11月-2019年4月浙江中医药大学附属第二医院骨关节科收治的60例行全膝关节置换术患者,按照随机数字表法分为A组、B组、C组,各20例。在术后常规镇痛基础上C组行中医定向透药,B组行耳穴压豆治疗,A组行中医定向透药和耳穴压豆治疗。评价各组治疗前后疼痛、关节活动度及治疗效果。结果治疗后7 d A组患者疼痛PRI、VAS、PPI评分分别为(5.46±0.15)分、(1.12±0.04)分、(0.89±0.04)分,均低于B组(6.24±0.10)分、(2.49±0.21)分、(1.16±0.17)分)、C组(6.21±0.50)分、(2.67±0.26)分、(1.26±0.24)分(F=29.024、42.990、10.371,均P<0.001)。A组患者治疗总有效率(95.00%)显著高于B组(55.00%)和C组(50.00%),差异有统计学意义(χ^2=10.950,P=0.004)。结论耳穴压豆联合中医定向透药可缓解患者全膝关节置换术后疼痛,促进关节功能恢复。

Objective To explore the effect of ear point pressing beans combined with directional penetration of traditional Chinese medicine on early pain and knee motion after total knee arthroplasty. Methods Total 60 patients with total knee arthroplasty in Department of Orthopedics and Arthrology, the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from November 2017 to April 2019 were randomly divided into group A, group B and group C, with 20 cases in each group. On the basis of routine postoperative analgesia, group C was treated with traditional Chinese medicine directed penetration, group B with auricular point pressing, group A with traditional Chinese medicine directed penetration and auricular point pressing. Pain, joint activity and therapeutic effect were evaluated. Results On 7 d after treatment, PRI, VAS and PPI scores of group A(5.46±0.15, 1.12±0.04, 0.89±0.04) were lower than those of group B(6.24±0.10, 2.49±0.21, 1.16±0.17) and group C(6.21±0.50, 2.67±0.26, 1.26±0.24, F Between the three groups/P Between the three groups=29.024/0.001, 42.990/0.001, 10.371/0.001). The total effective rate in group A(95.00%) was significantly higher than that in group B(55.00%) and group C(50.00%), with statistically significant difference(χ^2=10.950,P=0.004). Conclusion The combination of ear point pressing and traditional Chinese medicine directional penetration can relieve the pain of patients after total knee replacement and promote the recovery of joint function.