耳穴埋籽联合穴位敷贴对MRM术后患者疼痛、便秘的影响研究

Effects of auricular point pressing with seeds combined with acupoint application on pain and constipation in patients underwent modified radical mastectomy

目的探讨耳穴埋籽联合穴位敷贴对乳腺癌改良根治术(MRM)术后患者疼痛、便秘的影响,以期为临床治疗提供参考。方法选择2021年9月—2023年9月南通大学附属海安市人民医院收治的100例MRM术后患者为研究对象,采用随机数字表法将患者分为对照组和研究组,各50例。术后给予对照组患者常规治疗;在对照组干预基础上给予研究组患者耳穴埋籽联合穴位敷贴治疗。比较2组患者治疗前后臂围周径差值、上肢功能评分表(DASH)评分、视觉模拟评分法(VAS)评分、5-羟色胺水平、前列腺素E2水平、Wexner便秘评分、Bristol分类评分、血管活性肠肽(VIP)水平、匹兹堡睡眠质量指数(PSQI)评分,并比较2组患者治疗期间并发症发生情况。结果治疗前,2组患者臂围周径差值、DASH评分比较,差异均无统计学意义(P>0.05)。治疗后,2组患者臂围周径差值、DASH评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者VAS评分及血清5-羟色胺、前列腺素E2水平比较,差异无统计学意义(P>0.05)。治疗后,2组患者VAS评分及血清5-羟色胺、前列腺素E2水平均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者Wexner便秘评分、Bristol分类评分、VIP水平比较,差异无统计学意义(P>0.05)。治疗后,2组患者Wexner便秘评分低于治疗前,Bristol分类评分、VIP水平均高于治疗前,研究组患者Wexner便秘评分低于对照组,Bristol分类评分、VIP水平均高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者PSQI评分比较,差异无统计学意义(P>0.05)。治疗后,2组患者PSQI评分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论耳穴埋籽联合穴位敷贴可有效缩小MRM术后患者的臂围周径差值,改善上肢功能,缓解疼痛,改善便秘、睡眠质量,以及减少并发症的发生率,值得推广应用。

Objective To investigate the effects of auricular point pressing with seeds combined with acupoint application on pain and constipation in patients who underwent modified radical mastectomy(MRM),providing clinical treatment references.Methods One hundred MRM patients treated at Haian People's Hospital from September 2021 to September 2023 were selected and randomly assigned to a control group and a study group,with 50 patients in each.The control group received conventional treatment,while the study group additionally received auricular point pressing with seeds combined with acupoint application.The difference in upper arm circumference,Disabilities of the Arm,Shoulder,and Hand(DASH)scores,Visual Analogue Scale(VAS)scores,serotonin levels,prostaglandin E2 levels,Wexner constipation scores,Bristol stool classification,Vasoactive Intestinal Peptide(VIP)levels,Pittsburgh Sleep Quality Index(PSQI)scores,and complications during treatment were compared between the two groups.Results Before treatment,there were no significant differences in upper arm circumference difference and DASH scores between the two groups(P>0.05).After treatment,both indices were significantly lower in both groups,with the study group showing greater reductions(P<0.05).Before treatment,no significant differences were found in VAS scores,serotonin,and prostaglandin E2 levels(P>0.05).After treatment,these indices were significantly reduced in both groups,with greater reductions in the study group(P<0.05).Before treatment,no significant difference was observed in the Wexner constipation score,Bristol classification score,and VIP level between the 2 groups(P>0.05).After treatment,the Wexner constipation scores of the two groups were significantly decreased,and Bristol classification scores and VIP levels were significantly increased,with the Wexner constipation scores indicating greater reductions and Bristol classification scores and VIP levels demonstrating greater rise in the study group(P<0.05).Before treatment,no significant difference was found in PSQI scores between the two groups(P>0.05).After treatment,the PSQI scores of patients in the two groups were significantly decreased,with the study group demonstrating greater decline(P<0.05).The incidence rate of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion Auricular point pressing with seeds combined with acupoint application effectively reduces upper arm circumference differences,improves upper limb function,relieves pain,and alleviates constipation and sleep quality issues in MRM patients,with fewer complications,making it worthy of clinical promotion.