经皮穴位电刺激联合常规镇痛对无痛人流术后宫缩痛镇痛效果及机制研究

Study on the Analgesic Effect and Mechanism of Percutaneous Acupoint Electrical Stimulation Combined with Routine Analgesia on Uterine Contraction Pain after Painless Abortion

目的:探讨经皮穴位电刺激联合常规镇痛对无痛人流术后宫缩痛镇痛效果及机制。方法:选择来我院行无痛人流患者100例。根据随机数字表法分为两组。对照组行术后常规镇痛治疗,同时在内关、合谷、三阴交最酸胀处黏贴电极但是不进行穴位刺激。观察组在术后常规镇痛基础上行经皮穴位电刺激治疗。对比不同时间点两组患者的机体一般情况、不同时间点两组患者的宫缩痛疼痛情况、T3时正性负性情绪量表评分、T3时血清P物质、前列腺素、5-羟色胺、β-内啡肽、强啡肽水平、T4点时的心理状态评分及满意度评分。结果:对照组T1、T2点时的BP、HR、RR、SpO2明显较同组T0点低,对照组T3点与观察组T1、T2、T3点时BP、HR、RR、SpO2与同组T0点对比无统计学意义(P>0.05);对照组T1、T2点时的BP、HR、RR、SpO2明显较观察组同时间点低(P<0.05)。T0点,两组VAS评分对比无统计学意义(P>0.05);T1、T2、T3点时间,观察组的VAS评分明显较对照组低(P<0.05);对照组T1、T2点的VAS评分明显较同组T0点高,观察组T1、T2、T3点的VAS评分明显较T0点低(P<0.05)。观察组的正性情绪明显较对照组高,负性情绪明显较对照组低(P<0.05)。观察组的血清P物质、前列腺素、5-羟色胺、β-内啡肽、强啡肽水平明显较对照组低(P<0.05)。观察组的心理状态评分明显较对照组低,满意度评分明显较对照组高(P<0.05)。结论:经皮穴位电刺激联合常规镇痛可明显改善无痛人流术后宫缩痛镇痛效果、患者心理状态及满意度,可能与其可降低血清P物质、前列腺素、5-羟色胺、β-内啡肽、强啡肽水平有关。

Objective:To investigate the analgesic effect and mechanism of percutaneous acupoint electrical stimulation combined with routine analgesia on uterine contraction pain after painless abortion.Methods:100 patients were selected to receive painless abortion in our hospital.According to random number table method who were divided into two groups.The control group received routine postoperative analgesia treatment,and at the same time,electrodes were affixed to the most acid swelling of Neiguan,Hegu and Sanyin Jiao,but acupuncture point stimulation was not possible.The observation group was treated with percutaneous acupoint electrical stimulation on the basis of routine postoperative analgesia.The general body conditions of the two groups at different time points,the pain and pain of the two groups at different time points,the score of positive and negative emotion scale at T3,the level of serum substance P,prostaglandin,5-hydroxytryptamine,β-endorphin and dykephalin at T3,the score of psychological state and the score of satisfaction at T4 were compared.Results:The BP,HR,RR,SpO2 at T1 and T2 points in control group were significantly lower than T0 points in the same group,and there was no statistical significance in BP,HR,RR,SpO2 at T3 points in control group and T0 points in observation group(P>0.05).BP,HR,RR and SpO2 in control group were significantly lower than those in observation group at T1 and T2(P<0.05).At T0,there was no statistical significance in VAS scores between the two groups(P>0.05).At T1,T2 and T3 points,VAS scores in the observation group were significantly lower than those in the control group(P<0.05).The VAS scores at T1 and T2 points in the control group were significantly higher than those at T0 points in the same group,and the VAS scores at T1,T2 and T3 points in the observation group were significantly lower than those at T0 points(P<0.05).The positive emotion of the observation group was significantly higher than that of the control group,and the negative emotion was significantly lower than that of the control group(P<0.05).The serum levels of Substance P, prostaglandin, 5-hydroxytryptamine, β-endorphin and dynorphin in the observation group were significantly lower thanthose in the control group (P<0.05). The psychological status score of the observation group was significantly lower than control group,and the satisfaction score was significantly higher than control group (P<0.05). Conclusion: Percutaneous acupoint electrical stimulationcombined with routine analgesia can significantly improve the analgesic effect, psychological state and satisfaction of patients after painlessabortion, which may be related to the reduction of serum substance P, prostaglandin, 5-hydroxytryptamine, β-endorphin and dynorphinlevels.