温针灸在全髋关节置换术后辅助镇痛中的应用效果分析

【摘要】 目的 分析探讨温针灸在全髋关节置换术后辅助镇痛中的应用效果。方法 选取 2020年3月至2022 年 3 月鹤壁市人民医院收治的 98 例拟行全髋关节置换术治疗的患者作为研究对象, 按照术后不同镇痛方法将其分为针灸组 (49 例) 和常规组 (49 例), 针灸组患者全髋关节置换术后行镇痛泵联合温针灸镇痛, 常规组患者全髋关节置换术后行镇痛泵镇痛, 对比观察两组患者疼痛程度、血清前列腺素 E2 ( PGE2 ) 及 β-内啡肽(β-EP) 水平、髋关节功能与不良反应发生情况。结果 术后 6、12、48 h, 针灸组患者视觉模拟评分法 (VAS)评分均明显低于常规组 (t = 4.226、2.511、2.959, P<0.001、P= 0.014、P= 0.004); 术后 3 d, 针灸组患者血清PGE2 水平明显低于常规组 (t = 8.305, P<0.001)、血清 β-EP 水平明显高于常规组 (t = 8.808, P<0.001)。术后1、3、6 d, 针灸组患者髋关节屈曲活动度均明显大于常规组 ( t = 3.240、2.363、3.031, P = 0.002、0.020、0.003)。术后 1 周、1 个月及 2 个月, 针灸组患者 Harris 评分均明显高于常规组 ( t = 3.930、3.900、3.604, P均<0.001)。针灸组患者不良反应发生率为 6.12%, 明显低于常规组患者的不良反应发生率 20.41% ( χ2 = 4.346,P= 0.037)。结论 在常规镇痛泵镇痛基础上加用温针灸辅助镇痛可缓解全髋关节置换术后疼痛程度, 提高髋关节功能恢复效果, 疗效显著。

Clinical Efficacy of Warm Acupuncture on Analgesia after Total Hip Replacement

【Abstract】 Objective To analyze the clinical efficacy of warm acupuncture on analgesia after total hip replacement. Methods 98 patients admitted into Hebi People’s Hospital for total hip replacement between March 2020 and March 2022 were enrolled as research subjects and divided into the acupuncture group ( n = 49) and the routine group ( n = 49) based on different analgesia methods they received. After total hip replacement, the patients in the acupuncture group were given analgesia pump combined with warm acupuncture to relieve the pain, whereas the patients in the routine group were treated with analgesia pump for pain relief alone. The pain degree, serum prostaglandin E2 (PGE2 ) and β-endorphin (β-EP) levels, hip joint function and the occurrence of adverse reactions were compared between the two groups. Results Respectively at 6 h, 12 h and 48 h after surgery, the visual analogue scale (VAS) scores of patients in the acupuncture group were all significantly lower than those in the routine group (t = 4.226, 2.511 and 2.959, P<0.001, P= 0.014, P= 0.004). On day 3 after surgery, the serum PGE2 level of patients in the acupuncture group was significantly lower than that in the routine group (t = 8.305, P<0.001), and the serum β-EP level was markedly higher in the acupuncture group ( t = 8.808, P< 0.001). Respectively on day 1, day 3 and day 6 after surgery, the hip joint flexion ranges of patients in the acupuncture group were significantly larger than those in the routine group ( t = 3.240, 2.363 and 3.031, P = 0.002, 0.020 and 0.003). Respectively at week 1, month 1 and 2 after surgery, the Harris scores of patients in the acupuncture group were significantly higher than those in the routine group (t = 3.930, 3.900 and 3.604, all P<0.001). The incidence of postoperative adverse reactions of patients was 6.12% in the acupuncture group, being much lower than 20.41% in the routine group (χ2 = 4.346, P= 0.037). Conclusion The combined application of warm acupuncture with the conventional analgesia pump can significantly relieve patients’ pain after total hip replacement and enhance their recovery of hip joint functions, and the clinical efficacy is definite.