热敏灸预处理对膝关节镜手术患者炎性疼痛及血浆凝血因子Ⅹ活性的影响

Effect of Heat-sensitive Moxibustion Pretreatment on Inflammatory Pain and Plasma Coagulation FactorⅩActivity in Patients Undergoing Arthroscopic Knee Surgery

目的:研究膝关节镜手术患者在麻醉前接受热敏灸预处理的临床效果。方法:选择2021年7月—2023年2月在江西中医药大学附属医院接受膝关节镜手术治疗的患者120例,用随机数字表法将其分成对照组和研究组。对照组(n=60)术前实施腰硬联合麻醉,研究组(n=60)于术前3 d开始实施热敏灸预处理。对比两组疼痛情况、凝血因子Ⅹ活性、IL-6水平及血液流变学相关指标。结果:术前72 h、术后72 h,两组视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05);术后6、24、48 h,研究组VAS评分均低于对照组(P<0.05)。术后24、72 h,研究组IL-6水平均低于对照组(P<0.05)。术后24 h,研究组凝血因子Ⅹ活性低于对照组(P<0.05);术后72 h,两组凝血因子Ⅹ活性比较,差异无统计学意义(P>0.05)。术后24、72 h,研究组血浆黏度和全血黏度均低于对照组(P<0.05)。结论:膝关节镜手术患者在麻醉前,接受热敏灸预处理,可降低患者围手术期疼痛感,改善凝血功能,预防血栓形成,可作为膝关节镜手术患者炎性疼痛及血浆凝血因子Ⅹ活性改善的主要治疗方案。

Objective:To study the clinical effect of heat-sensitive moxibustion pretreatment in arthroscopic knee surgery patients before anesthesia.Method:A total of 120 patients who received arthroscopic knee surgery in Affiliated Hospital of Jiangxi University of Chinese Medicine from July 2021 to February 2023 were selected and divided into control group and study group according to random number table method.The control group(n=60)received combined spinal and epidural anesthesia before surgery,and the study group(n=60)began to receive heat sensitive moxibustion pretreatment 3 days before surgery.The pain status,coagulation factor X activity,IL-6 level and hemorheology related indexes of the two groups were compared.Result:72 h before surgery and 72 h after surgery,there were no significant differences in visual analogue scale(VAS)scores between the two groups(P>0.05).6,24 and 48 h after surgery,the VAS scores of the study group were lower than those of the control group(P<0.05).24 and 72 h after surgery,the levels of IL-6 in the study group were lower than those in the control group(P<0.05).24 h after surgery,the coagulation factor X activity in the study group was lower than that in the control group(P<0.05).72 h after surgery,there was no significant difference in coagulation factor X activity between the two groups(P>0.05).24,72 h after surgery,the plasma viscosity and whole blood viscosity of the study group were lower than those of the control group(P<0.05).Conclusion:Before anesthesia,patients with arthroscopic knee surgery receive heat-sensitive moxibustion pretreatment,which can reduce perioperative period pain,improve coagulation function,prevent thrombosis,and can be used as the main treatment plan for inflammatory pain and plasma coagulation factor X activity improvement in patients undergoing arthroscopic knee surgery.