中药穴位贴敷防治无痛人工流产术后恶心呕吐的临床研究

Effect of Acupoint Application of Traditional Chinese Medicine on Nausea and Vomiting after Painless Abortion

目的:观察中药穴位贴敷防治无痛人工流产术后恶心呕吐(PONV)的临床疗效。方法:选择广州市中西医结合医院2020年4月至2020年9月期间行无痛人工流产术患者300例,随机分为对照组、托烷司琼组和中药贴敷组,每组100例。对照组采用丙泊酚联合布托啡诺麻醉;托烷司琼组在丙泊酚联合布托啡诺麻醉基础上,静脉注射托烷司琼;中药贴敷组在丙泊酚联合布托啡诺麻醉基础上,实施中药穴位贴敷。收集每组患者人口学、麻醉及手术特征资料,随访术后24 h内恶心呕吐情况,分析比较上述指标在三组间的差异。结果:各组患者手术前后平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))的比较,以及三组患者丙泊酚用量、麻醉时间、手术时间的比较,差异无统计学意义(P>0.05)。对照组术后24 h内PONV发生率为19 %,明显高于托烷司琼组的7 %和中药贴敷组的5 %,差异具有统计学意义(P<0.05);在PONV严重级别上,对照组的1、2级的发生率均高于托烷司琼组和中药贴敷组,差异具有统计学意义(P<0.05)。而托烷司琼组和中药贴敷组在PONV发生率及严重级别上比较,差异无统计学意义(P>0.05)。结论:中药穴位贴敷能显著降低无痛人工流产PONV发生率及其严重程度,可明显提高患者术后舒适性。

Objective To explore effect of acupoint application of traditional Chinese medicine on post operative nausea and vomiting (PONV) for the patients with painless abortion surgery.Methods 300 patients who underwent painless abortion in Guangzhou Hospital of Integrated Traditional and Western Medicine from April 2020 to September 2020 were selected and randomly divided into control group,tropisetron group and Traditional Chinese medicine sticking group,with 100 patients in each group.The control group received propofol combined with butorphanol anesthesia.Tropisetron group was injected with propofol combined with butorphanol anesthesia.On the basis of propofol combined with butorphanol anesthesia,Chinese medicine acupoint application was applied in the group of Chinese medicine application.The demographic,anesthesia and surgical characteristics of patients in each group were collected,and the postoperative nausea and vomiting within 24 h were followed up to analyze and compare the differences of the above indicators among the three groups.Results There were no significant differences in mean arterial pressure (MAP),heart rate (HR),blood oxygen saturation (SpO_(2)) in each group before and after surgery were compared,as well as propofol dosage,anesthesia time,and operation time among the three groups were compared (P > 0.05).The incidence of PONV within 24 hours after operation was 19% in the control group,which was significantly higher than 7% in the tropisetron group and 5% in the traditional Chinese medicine sticking group,and the difference was statistically significant (P < 0.05).In the severity level of PONV,the incidence rates of grades 1 and 2 in the control group were higher than those in the tropisetron group and the traditional Chinese medicine sticking group,and the difference was statistically significant (P < 0.05).The tropisetron group and the traditional Chinese medicine sticking group were compared in the incidence and severity of PONV,and the difference was not statistically significant (P > 0.05).Conclusion Traditional Chinese medicine acupoint application can significantly reduce the incidence and severity of PONV,and can significantly improve the postoperative comfort of patients.