电揿针疗法对清宫术的镇痛效果安全性及转归的临床价值

Analgesic effect and safety and clinical value of electronic snap needle therapy on in⁃duced labor curettage

目的探讨电揿针疗法对清宫术的镇痛效果、安全性及转归的临床价值。方法2017年6月—2019年6月在东阳市妇幼保健院产科行清宫术的妇女60例,随机分为对照组和电揿针组,每组30例。对照组无任何干预方式,出现急性疼痛采用按摩和热敷缓解,电揿针组采用50 Hz的电揿针,比较两组术中及术后12 h、24 h、36 h及48 h的相关结果,包括:治疗效果(疼痛评分、出血量及血清泌乳素)、安全性(体温、心率及血压)以及疼痛发生频率。结果电揿针组在行清宫术1 min、术中任意时刻及清宫术完成前1 min的疼痛评分[(2.33±0.21)分、(3.52±0.31)分及(4.01±0.42)分]与出血量[(21.00±0.52)ml、(81.00±0.82)ml及(161.00±0.14)ml]与对照组[(3.42±0.11)分、(5.38±0.33)分、(6.18±0.42)分,(34.00±0.32)ml、(102.00±1.21)ml及(202.19±2.13)ml]比较,差异均有统计学意义(均P<0.05);在术后12 h、24 h及36 h,电揿针组的疼痛评分[(6.38±0.63)分、(4.22±0.71)分及(2.11±0.46)分]、出血量[(261±2.32)ml、(291±4.32)ml及(61±1.94)ml]与对照组[(7.32±0.23)分、(6.38±0.63)分及(5.38±0.93)分,(254.00±1.23)ml、(332.00±3.41)ml及(4.29±3.71)ml]比较,差异均有统计学意义(均P<0.05)。电揿针组的血清泌乳素在术后12 h、24 h[(2.93±2.11)ng/ml,(2.51±1.12)ng/ml]与对照组比较,差异均有统计学意义(均P<0.05);两组患者的体温、心率及血压比较,差异均无统计学意义(均P>0.05);在术后12 h、24 h、36 h及48 h,电揿针组的疼痛发生频率(4.22±0.41、3.24±0.22、1.02±0.27及0.32±0.01)与对照组(7.22±0.52、6.29±0.19、2.11±0.43及1.01±0.23)比较,差异均有统计学意义(均P<0.05);电揿针组的术后48 h的痊愈率(50.00%)、有效率(46.67%)、无效率(3.33%)及总有效率(96.67%)与对照组的(36.67%、50.00%、13.33%及86.67%)比较,差异均有统计学意义(均P<0.05)。结论相对于传统针灸方法,电揿针疗法对清宫术后的镇痛效果理想、安全性高,可以短时间内发挥镇痛效果,广泛适用于清宫术后镇痛。

Objective To explore the analgesic effect,safety and clinical value of Electroacupuncture on induced labor curettage.Methods From June 2017 to June 2019,60 parturients who underwent induced labor and palace cleaning in the obstetrics department of our hospital were randomly divided into two groups,the reference group and the electroacupuncture group,with 30 cases in each group.There was no intervention in the reference group,and acute pain was alleviated by massage and hot compress.The electroacupuncture group used 50 Hz electroacupuncture.The relevant results of the two groups during and at 12h,24h,36h and 48h after operation were compared,including:treatment effect(pain score,bleeding volume and serum prolactin),safety(body temperature,heart rate and blood pressure),and pain frequency.Results The pain scores[(2.33±0.21),(3.52±0.31)and(4.01±0.42)points]and the bleeding volume[(21±0.52)ml,(81±0.82)ml and(161.00±0.14)ml]in the electroacupuncture group at 1 min after the operation,at any time during the operation and 1 min before the completion of the operation were significantly different from those in the control group[(3.42±0.11)points,(5.38±0.33)points,(6.18±0.42)points,(34.00±0.32)ml,(102.00±0.21)ml and(202.19±2.13)ml],The difference was statistically significant(all P<0.05);At 12h,24h and 36h after operation,the pain score[(6.38±0.63),(4.22±0.71)and(2.11±0.46)points]and the bleeding volume[(261.00±2.32)ml,(291.00±4.23)ml and(61.00±1.94)ml]of the electroacupuncture group were compared with those of the control group[(7.32±0.23)points,(6.38±0.63)points and(5.38±0.93)points,(254.00±1.23)ml,(332.00±3.41)ml and(4.29±3.71)ml].The difference was statistically significant(all P<0.05).The serum prolactin of the electroacupuncture group was significantly different from that of the control group at 12h and 24h after operation(all P<0.05);There were significant differ⁃ences in body temperature,heart rate and blood pressure between the two groups(all P>0.05);At 12h,24h,36h and 48h after operation,the frequency of pain in the electroacupuncture group(4.22±0.41,3.42±0.22,1.02±0.27 and 0.32±0.01)was significantly different from that in the control group(7.22±0.52,6.29±0.19,2.11±0.43 and 1.01±0.23)(all P<0.05);The recovery rate(50.00%),the effective rate(46.67%),the ineffective rate(3.33%)and the total effective rate(96.67%)of the electroacupuncture group 48 hours af⁃ter operation were significantly different from those of the control group(36.67%,50.00%,13.33%and 86.67%)(all P<0.05).Con⁃clusion Compared with traditional acupuncture and moxibustion,electroacupuncture has ideal analgesic effect and high safety after induced labor and uterine cleaning,and can exert analgesic effect in a short time.It is widely applicable to analgesia after induced labor and uterine cleaning.