耳穴电刺激治疗下肢动脉硬化闭塞症患者静息痛的临床效果

Clinical efficacy of auricular point electrical stimulation on rest pain in patients with arteriosclerosis obliterans of lower limbs

目的通过随机对照试验探究耳穴电刺激治疗下肢动脉硬化闭塞症(ASO)患者静息痛的临床效果。方法选取2017年1月至2019年12月于首都医科大学附属北京中医医院收治的61例下肢ASO引起静息痛的患者作为研究对象,根据随机数表法分为观察组(30例)与对照组(31例)。观察组采用耳针治疗仪进行治疗,刺激耳甲腔迷走神经区域;对照组亦佩戴耳针治疗仪,但耳夹不通电。在治疗1、4、8周后,比较两组疼痛视觉模拟评分(VAS)、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分。结果经耳穴电刺激4、8周后,观察组VAS评分均显著低于对照组(P<0.01),且均低于耳穴电刺激1周后的VAS评分(P<0.01)。而在心理状态方面,观察组的HAMD评分、HAMA评分、SDS评分、SAS评分均低于对照组,且差异均有统计学意义(P<0.05);但与观察组耳穴电刺激1周后比较,观察组耳穴电刺激8周后的HAMD、HAMA、SDS及SAS均显著降低(P<0.05)。结论耳穴电刺激4、8周可以有效缓解ASO患者的静息痛,并能一定程度改善患者抑郁、焦虑的心理状态。

Objective To explore the clinical efficacy of auricular point electrical stimulation in the treatment of rest pain in patients with arteriosclerosis obliterans(ASO)of lower limbs through a randomized controlled trial.Methods A total of 61 patients with rest pain due to ASO of lower limbs who were admitted to Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January 2017 to December 2019 were selected as the study objects,and were divided into the observation group(30 patients)and the control group(31 patients)according to the random number table method.The observation group was treated with auricular acupuncture apparatus to stimulate the vagus nerve region in cavum conchae,while the control group was also treated with auricular acupuncture apparatus,with ear clip not energized.After 1,4 and 8 weeks of treatment,scores of pain visual analogue scale(VAS),Hamilton depression scale(HAMD)Hamilton anxiety scale(HAMA),self-rating depression scale(SDS)and self-rating anxiety scale(SAS)of the two groups were compared.Results After 4 and 8 weeks of auricular electrical stimulation,the VAS score of the observation group was significantly lower than that of the control group(P<0.01),and the scores of both groups were lower than those in the two groups after 1 week of auricular point electrical stimulation(P<0.01).In the aspect of psychological state,scores of HAMD,HAMA,SDS and SAS of the observation group were lower than those of the control group,with statistically significant differences(P<0.05).Compared with the observation group after 1 week of auricular point electrical stimulation,the HAMD,HAMA,SDS,and SAS of the observation group after 8 weeks of auricular point electrical stimulation were significantly reduced(P<0.05).Conclusion Four and eight weeks of auricular point electrical stimulation can effectively alleviate the rest pain in patients with ASO of lower limbs and improve the psychological state of depression and anxiety in patients to a certain extent.