胸腔镜术后穴位贴敷结合穴位针刺治疗的疼痛改善效果
|
摘要
目的探讨胸腔镜术后采用穴位贴敷结合穴位针刺治疗对患者疼痛的改善效果。方法选取本院收治的160例行胸腔镜手术患者,随机分为观察组和对照组各80例。对照组只使用PCA自控镇痛法止痛;观察组在PCA自控镇痛法止痛的基础上,从术后4 h开始使用穴位贴敷,并在术后4、8、24、48 h行穴位针刺治疗。比较分析患者直观模拟量表法(VAS)评分和疼痛问卷(SF-MPQ)评分,统计术后48h以后治疗的有效率;对比2组患者术后4 h和48 h外周血中儿茶酚胺,多巴胺(DA)、去甲状腺素(NA)、肾上腺素(Ad)。结果 2组患者的VAS评分、SF-MPQ评分均有所下降,观察组评分低于对照组(P<0.05),且观察组有效率优于对照组(P<0.05);2组间的DA、NA、Ad含量相当,无统计学差异(P>0.05)。结论穴位贴敷结合穴位针刺治疗对缓解胸腔镜术后患者的疼痛有显著效果。
Objective To study the effect of acupoint sticking combined with acupuncture after thoracoscopic surgery on the improvement of pain. Methods A total of 160 patients undergoing thoracoscopic surgery in our hospital were divided into observation group and control group,with 80 cases in each group. The patients in the control group were only used PCA self controlled analgesia to relieve pain. The patients in the observation group were used acupoint sticking at 4 h after surgery,and the acupuncture treatment was implemented at 4,8,24 and 48 h after operation on the basis of control group. The patient's visual analog scale( VAS) score and the pain questionnaire( SF-MPQ)score were compared,and the treatment efficiency after 48 h was statistically analyzed. Catecholamine( DA),thyroid hormone( NA),and adrenaline( Ad) in peripheral blood at 4,48 h of two groups were compared. Results The VAS scores and SF-MPQ scores of the two groups were all decreased,and the observation group decreased more significantly than that of the control group( P < 0. 05),and the observation group had better treatment efficacy than the control group( P < 0. 05). There were no significant differences in DA,NA and Ad between the two groups( P > 0. 05). Conclusion Acupoint sticking combined with acupuncture has significant effect on relieving pain of patients after thoracoscopy.
Objective To study the effect of acupoint sticking combined with acupuncture after thoracoscopic surgery on the improvement of pain. Methods A total of 160 patients undergoing thoracoscopic surgery in our hospital were divided into observation group and control group,with 80 cases in each group. The patients in the control group were only used PCA self controlled analgesia to relieve pain. The patients in the observation group were used acupoint sticking at 4 h after surgery,and the acupuncture treatment was implemented at 4,8,24 and 48 h after operation on the basis of control group. The patient's visual analog scale( VAS) score and the pain questionnaire( SF-MPQ)score were compared,and the treatment efficiency after 48 h was statistically analyzed. Catecholamine( DA),thyroid hormone( NA),and adrenaline( Ad) in peripheral blood at 4,48 h of two groups were compared. Results The VAS scores and SF-MPQ scores of the two groups were all decreased,and the observation group decreased more significantly than that of the control group( P < 0. 05),and the observation group had better treatment efficacy than the control group( P < 0. 05). There were no significant differences in DA,NA and Ad between the two groups( P > 0. 05). Conclusion Acupoint sticking combined with acupuncture has significant effect on relieving pain of patients after thoracoscopy.
引文
[1]丁凯,周晓燕,吕剑,等.完全电视胸腔镜手术在胸部疾病诊疗中的应用[J].山东医药,2015,10(1):84-85.
[2]郝志鹏,蔡奕欣,付圣灵,等.单孔与三孔胸腔镜肺癌根治术对患者术后疼痛及短期生活质量的对比研究[J].中国肺癌杂志,2016,19(3):122-128.
[3]张云霄,陈冀衡,万有,等.针药复合麻醉对胸腔镜肺癌根治术患者术后镇痛效果的影响[J].中国疼痛医学杂志,2015,21(3):206-209.
[4]高强方.胸腔镜肺癌根治术患者围术期疼痛物质及炎性介质变化研究[J].实用癌症杂志,2015,30(8):1174-1176.
[5]寿伟臻,张琨,俞杞泉,等.针刺配合穴位敷贴对减轻胸部手术后创口疼痛的临床评价[J].上海中医药大学学报,2016(6):34-37.
[6]黄鹂.综合护理干预对外科患者术后疼痛程度的影响[J].医学临床研究,2015,17(2):117-118.
[7]刘慧丽,张小青,李跃新,等.不同多模式镇痛策略对腹腔镜手术后疼痛的影响[J].临床麻醉学杂志,2014,30(3):235-238.
[8]成娟.穴位贴敷缓解痔疮术后疼痛的效果评价[J].中国药物与临床,2016,16(2):266-268.
[9]谢睿.痔痛消散穴位外敷治疗痔疮术后疼痛疗效观察[J].山东中医药大学学报,2016,25(3):260-261.
[10]郑凯,宋杰,高玉,等.针刺缓解肺癌中重度癌性疼痛临床观察[J].辽宁中医药大学学报,2015,19(1):19-21.
[11]赵艳,蔡云,朱翠萍.针刺与硬膜外麻醉在分娩镇痛中疗效与安全性比较的随机对照试验[J].中国中西医结合急救杂志,2016,23(2):160-163.
[12]吕国蔚.穴位传入与针刺镇痛的基础与临床研究[J].神经解剖学杂志,2016,32(1):119-123.
[13]林玉芳,李寅,万钰茜,等.肛肠手术行穴位经皮刺激复合药物麻醉的抗应激效应及镇痛效应研究[J].上海中医药大学学报,2015,29(4):30-33.
[14]钱雄杰.痔术后针刺镇痛疗效观察[J].浙江中西医结合杂志,2015,25(5):475-477.
[15]陈丽,王健.针刺镇痛之体液调节机制研究进展[J].上海中医药杂志,2015,10(11):91-93.
[2]郝志鹏,蔡奕欣,付圣灵,等.单孔与三孔胸腔镜肺癌根治术对患者术后疼痛及短期生活质量的对比研究[J].中国肺癌杂志,2016,19(3):122-128.
[3]张云霄,陈冀衡,万有,等.针药复合麻醉对胸腔镜肺癌根治术患者术后镇痛效果的影响[J].中国疼痛医学杂志,2015,21(3):206-209.
[4]高强方.胸腔镜肺癌根治术患者围术期疼痛物质及炎性介质变化研究[J].实用癌症杂志,2015,30(8):1174-1176.
[5]寿伟臻,张琨,俞杞泉,等.针刺配合穴位敷贴对减轻胸部手术后创口疼痛的临床评价[J].上海中医药大学学报,2016(6):34-37.
[6]黄鹂.综合护理干预对外科患者术后疼痛程度的影响[J].医学临床研究,2015,17(2):117-118.
[7]刘慧丽,张小青,李跃新,等.不同多模式镇痛策略对腹腔镜手术后疼痛的影响[J].临床麻醉学杂志,2014,30(3):235-238.
[8]成娟.穴位贴敷缓解痔疮术后疼痛的效果评价[J].中国药物与临床,2016,16(2):266-268.
[9]谢睿.痔痛消散穴位外敷治疗痔疮术后疼痛疗效观察[J].山东中医药大学学报,2016,25(3):260-261.
[10]郑凯,宋杰,高玉,等.针刺缓解肺癌中重度癌性疼痛临床观察[J].辽宁中医药大学学报,2015,19(1):19-21.
[11]赵艳,蔡云,朱翠萍.针刺与硬膜外麻醉在分娩镇痛中疗效与安全性比较的随机对照试验[J].中国中西医结合急救杂志,2016,23(2):160-163.
[12]吕国蔚.穴位传入与针刺镇痛的基础与临床研究[J].神经解剖学杂志,2016,32(1):119-123.
[13]林玉芳,李寅,万钰茜,等.肛肠手术行穴位经皮刺激复合药物麻醉的抗应激效应及镇痛效应研究[J].上海中医药大学学报,2015,29(4):30-33.
[14]钱雄杰.痔术后针刺镇痛疗效观察[J].浙江中西医结合杂志,2015,25(5):475-477.
[15]陈丽,王健.针刺镇痛之体液调节机制研究进展[J].上海中医药杂志,2015,10(11):91-93.