摘要
目的:观察电针对全膝关节置换术(total knee arthroplasty,TKA)后患者的辅助镇痛作用,并探讨其作用机制。方法:将40例重度膝关节骨关节炎患者随机分为观察组和对照组,每组20例。术中两组患者均采用硬膜外麻醉,术后采用常规硬膜外自控式镇痛及口服塞来昔布胶囊止痛,观察组于术后第1天至第7天采用电针疗法辅助止痛,穴位选取术侧梁丘、血海、阴陵泉、足三里、丰隆及丘墟,每次30 min,每天1次。记录患者术后静息、活动状态疼痛视觉模拟评分(visual analogue scale,VAS)。于术后第1、7天检测两组患者血清前列腺素E2及β-内啡肽水平。结果:于术后第3、5、7天静息状态及活动状态VAS评分观察组均优于对照组(均P<0.05);治疗后两组血清β-内啡肽水平均提高、前列腺素E2水平降低(均P<0.05),且观察组变化幅度均大于对照组(均P<0.05)。结论:电针对全膝关节置换术后患者有辅助镇痛作用,促进β-内啡肽的合成及抑制前列腺素E2的合成是其可能作用机制之一。
Objective To observe the effect on supplementary analgesia after total knee arthroplasty(TKA) treated with electroacupunture, and explore it’s mechanism. Methods A total of 40 patients with severe knee osteoarthritis were randomized into an observation group and a control group, 20 cases in each one. During the operation, patients were given epidural anesthesia in the two groups, conventional patient controlled epidural analgesia and oral celecoxib were applied after the operation. In the observation group, electroacupunture was used at Liangqiu(ST 34), Xuehai(SP 10),Yinlingquan(SP 9), Zusanli(ST 36), Fenglong(ST 40) and Qiuxu(GB 40) on the operation side from the 1 st to 7 th day after the operation to support analgesia, 30 min for each time, once a day. The visual analogue scale(VAS) was used to record postoperative pain of resting state and active state. The levels of serum prostaglandin E2 and β-endorphin were measured on the 1 st and 7 th day after surgery in the two groups. Results In the observation group, the VAS scores of resting state and active state were superior to the control group on the 3 rd, 5 th and 7 th day after the operaton(all P<0.05);after the treatment, the level of serum β-endorphin was increased and the level of serum prostaglandin E2 was reduced in the two groups(all P<0.05), and the change of the observation group was larger than that of the control group(both P<0.05).Conclusion Electroacupunture has the effect of supplementary analgesia for patients after TKA, the mechanism may be related to promote the synthesis of β-endorphin and inhibit the synthesis of prostaglandin E2.
作者
陈达
盛东
徐景利
张泱悦
林天烨
张庆文
CHEN Da;SHENG Dong;XU Jing-li;ZHANG Yang-yue;LIN Tian-ye;ZHANG Qing-wen(the First Hospital Affiliated to Guangzhou University of CM,Guangzhou 510000,Guangdong Province,China;Department of Orthopaedics,Chongqing Orthopedics Hospital of TCM;the First Clinical Medical School,Guangzhou University of CM)
出处
《中国针灸》
CAS
CSCD
北大核心
2019年第3期247-250,共4页
Chinese Acupuncture & Moxibustion
基金
广东省科技计划项目:2014A020212556
关键词
全膝关节置换术
电针
Β-内啡肽
前列腺素E2
镇痛
total knee arthroplasty
electroacupunture
β-endorphin
prostaglandin E2
analgesia
作者简介
通信作者:张泱悦,主任护师。E-mail:934523870@qq.com。
