揿针联合耳穴压豆对髋关节置换术后患者功能恢复及疼痛状况的影响

Effect of Qin-acupuncture combined with auricular point pressing with bean on functional recovery and pain status of patients after hip arthroplasty

目的 探讨揿针联合耳穴压豆对髋关节置换术后患者髋关节功能恢复及疼痛状况的影响。方法 选取2019年1月至2021年12月于北京中医药大学孙思邈医院行髋关节置换术的80例患者为研究对象,依据随机数表法分为对照组与联合组,每组40例。对照组患者术后给予静脉自控镇痛,时间为24 h;联合组患者在对照组的静脉自控镇痛基础上给予揿针联合耳穴压豆治疗,疗程6 d。比较两组患者术后6 h、12 h、24 h、36 h、48 h、72 h视觉模拟量表(VAS)评分、术前与术后7 d髋关节(Harris)评分、术前及术后3 d的P物质(SP)、前列腺素E2 (PGE2)、5羟色胺(5-HT)水平及不良反应发生情况。结果 联合组患者术后6 h、12 h、24 h的VAS评分分别为(6.34±0.55)分、(5.69±0.50)分、(5.11±0.42)分,明显低于对照组的(7.81±0.63)分、(7.06±0.57)分、(6.15±0.48)分,差异均有统计学意义(P<0.05);术后48 h、72 h、7 d,联合组患者的VAS评分分别为(4.72±0.30)分、(4.35±0.33)分、(3.71±0.14)分,与对照组的(4.84±0.28)分、(4.42±0.26)分、(3.78±0.22)分比较差异均无统计学意义(P>0.05);术前,两组患者的Harris评分比较差异无统计学意义(P>0.05);术后7 d,两组患者的Harris评分均明显高于术前,且联合组患者的Harris评分为(68.81±13.79)分,明显高于对照组的(62.02±12.81)分,差异均有统计学意义(P>0.05);术前,两组患者的SP、PGE2、5-HT水平比较差异均无统计学意义(P>0.05);术后3 d,两组患者的SP、PGE2、5-HT水平明显高于术前,但联合组患者的SP、PGE2、5-HT水平分别为(113.48±11.45) pg/mL、(43.36±2.98) ng/mL、(692.84±17.11)μmol/L,明显低于对照组的(140.27±10.59) pg/mL、(61.16±2.44) ng/ml、(745.18±16.37)μmol/L,差异均有统计学意义(P>0.05);联合组患者的总不良反应发生率为12.50%,略高于对照组的10.00%,差异无统计学意义(P>0.05)。结论 揿针联合耳穴压豆应用于髋关节置换术后可显著改善患者髋关节功能,并于短期内有效缓解其疼痛,同时不良反应较少,值得推广应用。

Objective To investigate the effect of Qin-acupuncture combined with auricular point pressing with bean on functional recovery and pain of patients after hip replacement. Methods A prospective analysis was conducted on 80 patients who underwent hip replacement in Sun Simiao Hospital of Beijing University of Traditional Chinese Medicine from January 2019 to December 2021, which were divided into a control group and a combined group according to random number table, with 40 patients in each group. Patients in the control group were given patient-controlled intravenous analgesia for 24 hours, and those in the combined group were treated with Qin-acupuncture combined with auricular point pressing with bean on the basis of the treatment in the control group, for 6 days. Postoperative 6 h, 12 h, 24 h, 36 h, 48 h, 72 h Visual Analogue Scale(VAS) score, preoperative and postoperative 7 days hip joint(Harris) score, substance P(SP), prostaglandin E2(PGE2), and serotonin(5-HT) levels before and 3 days after surgery, and the incidence of adverse reactions were compared between the two groups. Results The VAS scores of the combined group at 6 h, 12 h, and 24 h after operation were(6.34±0.55) points,(5.69±0.50) points, and(5.11±0.42) points, which were significantly lower than(7.81±0.63) points,(7.06±0.57) points, and(6.15±0.48) points in the control group(P<0.05);at 48 h, 72 h, and 7 d after operation, the VAS scores in the combined group were(4.72±0.30) points,(4.35±0.33) points,(3.71±0.14) points, which showed no statistically significant difference as compared with(4.84±0.28) points,(4.42±0.26) points, and(3.78±0.22) points in the control group(P>0.05). Before surgery, there was no significant difference in Harris score between two groups(P>0.05). At 7 days after surgery, the Harris scores of the two groups were significantly higher than those before surgery, and the Harris score of the combined group was(68.81±13.79) points, which was significantly higher than(62.02±12.81) points of the control group(P<0.05). Before surgery,there were no significant difference in SP, PGE2, 5-HT levels between the two groups(P>0.05);at 3 days after surgery,the levels of SP, PGE2, and 5-HT in the two groups were significantly higher than those before surgery, and the levels in the combined group were(113.48±11.45) pg/mL,(43.36±2.98) ng/mL,(692.84±17.11) μmol/L, significantly lower than(140.27±10.59) pg/mL,(61.16±2.44) ng/mL,(745.18±16.37) μmol/L in the control group(P<0.05). The incidence of adverse reactions in the combined group was 12.50%, which was not significantly different from 10.00% in the control group(P>0.05). Conclusion Qin-acupuncture combined with auricular point pressing with bean can significantly improve the hip joint function of patients after hip arthroplasty, and effectively relieve their pain in the short term, with few adverse reactions, which is worthy of popularization and application.