小剂量吗啡内关穴注射治疗急性心肌梗死之胸痛

目的:探寻治疗急性心梗胸痛时吗啡的有效注射途径。方法:将临床确诊为心肌梗死的患者90例随机分为3组,每组30例。穴位注射组行双侧内关穴分别注射吗啡2 mg,静脉注射组采用吗啡5 mg静脉注射,皮下注射组采用吗啡5 mg皮下注射,其他治疗3组相同。采用视觉模拟评分法(VAS)观察3组病人治疗5、10、30、60、180 min后镇痛效果,并记录并发症。结果:治疗前3组VAS评分比较差异无统计学意义(均P>0.05);治疗后5 min、30 min、180 min镇痛效果穴位注射组优于其他2组(均P<0.01);穴位注射组恶心、呕吐发生率为3.3%,低于静脉注射组的40.0%和皮下注射组的20.0%(均P<0.01)。结论:小剂量吗啡内关穴注射治疗急性心梗时的胸痛疗效确切,镇痛效果好,吗啡用量少,镇痛时间长,吗啡并发症少。

Clinical observation on injection of small dose of Morphine into Neiguan (PC 6) for treatment ofchest pain in the patient with acute myocardial infarction

Objective To probe into an effective injection way of Morphine for treatment of chest pain of acute cardiac infarction.Methods Ninety cases of myocardial infarction were randomly divided into 3 groups,an acupoint-injection group,an intravenous injection group and a hypodermic injection group,30 cases in each group.The acupoint-injection group were treated with injection of 2 mg Morphine into bilateral Neiguan(PC 6) respectively,and the intravenous injection group with intravenous injection of 5 mg Morphine and the hypodermic injection group with hypodermic injection of 5 mg Morphine,and other treatments were same in the 3 groups.The analgesic effects were assessed with visual analogue scale(VAS) 5,10,30,60 and 180 minutes after treatment and the complications were observed.Results There were no significant differences among the 3 groups before treatment in the VAS score(P>0.05).The analgesic effect in the acupoint-injection group was better than those in other two groups 5 min,30 min and 180 min after treatment(all P<0.01).The incidence rate of nausea and vomiting of 0.3% in the acupoint-injection group was significantly lower than 40.0% in the intravenous injection group and 20.0% in the hypodermic injection group(all P<0.01).Conclusion Injection of small dose of Morphine into Neiguan(PC 6) has a definite therapeutic effect on chest pain of acute myocardial infarction with earlier analgesic effect,smaller dose of Morphine,longer analgesic duration and less complications.