电针治疗混合痔外剥内扎术后疼痛的临床研究

Clinical study on electroacupuncture in the treatment of postoperative pain of mixed hemorrhoids after internal binding and external excising

目的探索电针治疗混合痔外剥内扎手术后疼痛的临床疗效。方法将2020年5—9月上海中医药大学附属第七人民医院肛肠科收治的90例混合痔患者随机分为治疗组和对照组,每组45例。2组均于术后8 h内患者发生疼痛时予以干预,取穴为双侧合谷、太冲、足三里和外关。治疗组采取电针治疗,频率2 Hz,刺激强度1~2 mA(以患者耐受为宜),波形为连续波,时间为20 min。对照组采取安慰剂假针,不刺入皮肤,电针仪归零,留针时间同治疗组。比较患者电针治疗0.5,1,2,3,4 h后疼痛强度评分;排便后2 h内电针治疗后疼痛强度评分;电针治疗后12 h内患者口服双氯芬酸钠缓释片剂量。结果2组第1次电针治疗后,治疗组治疗0.5,1,2,3,4 h后NRS、BRS评分和治疗2,3 h后肢体活动度评分均明显低于对照组(P均<0.05)。首次排便电针治疗后,治疗组0.5,1 h后的NRS、BRS和肢体活动度评分均明显低于对照组(P均<0.05)。治疗组第1次电针治疗后12 h内口服双氯芬酸钠缓释片的剂量为(0.58±0.54)片,低于对照组的(1.20±0.73)片,差异有统计学意义(P<0.05)。结论通过辨证取穴运用电针治疗混合痔术后疼痛能显著缓解患者的疼痛症状,减少患者术后服用双氯芬酸钠缓释片的剂量。

Objective It is to explore the clinical effect of electroacupuncture in the treatment of postoperative pain of mixed hemorrhoids after internal binding and external excising.Methods Ninety patients with mixed hemorrhoids admitted to the Anorectal Department of the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine from May to September 2020 were randomly divided into a treatment group and a control group,with 45 cases in each group.Both groups were intervened when the patients experienced pain within 8 h after operation.The acupoints selected were bilateral Hegu,Taichong,Zusanli and Waiguan.The treatment group was treated with electroacupuncture at a frequency of 2 Hz,a stimulation intensity of 1 to 2 mA(appropriate to be tolerated by the patient),a continuous wave waveform,and a duration of 20 min.The control group was treated with placebo fake needles without piercing the skin,the electroacupuncture device was reset to zero,and the needle retention time was the same as that of the treatment group.The patients’pain intensity scores after 0.5,1,2,3,4 h of electro-acupuncture treatment,pain intensity scores after electro-acupuncture treatment within 2 h after defecation,the dose of oral diclofenac sodium sustained-release tablets within 12 h after electro-acupuncture treatment were compared between the two groups.Results After the first electroacupuncture treatment in the 2 groups,the NRS and BRS scores of the treatment group after treatment for 0.5,1,2,3,4 h and the limb activity scores after treatment for 2,3 h were significantly lower than those of the control group(All P<0.05).After the first defecation of electroacupuncture treatment,the NRS,BRS and limb mobility scores of the treatment group after treatment for 0.5 and 1 h were significantly lower than those of the control group(all P<0.05).The dose of diclofenac sodium sustained-release tablets in the treatment group within 12 h after the first electroacupuncture treatment was(0.58±0.54)tablets,which was lower than(1.20±0.73)tablets in the control group,the difference was statistically significant(P<0.05).Conclusion Electroacupuncture through differentiation of symptoms and signs can significantly alleviate the pain symptoms of patients and reduce the dose of diclofenac sodium sustained-release tablets in the treatment of postoperative pain of mixed hemorrhoids after surgery.