摘要
目的探讨病人自控镇痛（PCA）配合中医辨证治疗血栓闭塞性脉管炎（主要是早、中期）的临床应用效果及探讨应用方法。方法46例血栓闭塞性脉管炎（简称“脉管炎”）患者，随机分为两组。Ⅰ组，无镇痛组23例。Ⅱ组，病人自控镇痛（PCA）加中医辨证治疗组23例。自控镇痛（PCA）液组成，上肢以静脉PCA（PCIA），配方为芬太尼10～12μg/ml加0．01％氟哌利多。下肢以硬膜外PCA（PCEA），配方为芬太尼2μg／ml加0．125％罗哌卡因加0．01％氟哌利多，持续给药4～6d。临床辨证时应注意以局部症状为主，抓住主要症状，结合西医分期进行辨证治疗。结果Ⅱ组镇痛效果明显优于I组，经统计学比较二者差异显著（P〈0．05），Ⅱ组间歇性跛行，静息痛感消退明显优于I组，经统计学比较二者差异显著（p〈0．05）。结论病人自控镇痛（PCA）配合中医辨证治疗早、中期血栓闭塞性脉管炎能快速减轻病人疼痛，改善局部血液循环，促进炎症消退，从而改善病人因疼痛引起的焦虑和不稳定情绪，提高治疗效果，是一种具有临床价值的治疗方法。
Objective Discuss on the patient self control analgesia （PCA） coordinate with the Chinese traditional dialectical medicine to treat thromboangitis obliterans （mainly in early and intermediate stage） enlightening the clinical practical effect and the application method. Methods 46 patients with thromboangitis obliterans were randomly divided into two groups. Group I with 23 examples does not have the analgesia. Group II with 23 examples, received patient self control analgesia （PCA） ＋ Chinese traditional dialectical medicine treatment. The formula of fluid used in PCA for upper limb intravenous dropping is Nepal 10 -12 g/ml ＋0. 01% droperdial; that of fluid used epidurally for lower limb is Nepal 2 g/ml ＋ 0. 125% ropivacaine. Both used continuously for 4 - 6 day. In Chinese traditional dialectical treatment should pay attention to the partial symptom primarily, holds the main symptom, unifies the doctor practicing western medicine to carry on the dialectical treatment by stages. Results In group II the analgesic effects obviously surpass group I, after statistics comparison the difference is remarkable （p 〈 0. 05）, Group II intermittent elaudication, rest pain dissipated significantly better than Group I, statistical/y compare the difference is significant （p 〈0. 05）. Conclusion The patient self control analgesia （PCA） coordinate with the Chinese traditional dialectical medicine treatment in early and intermediate stage of thromboangitis obliterans can rapidly reduce patient＇ s ache, improve partial blood circulation, the promotion inflammation abates, thus prevent patient from anxious caused by ache and does not set minds at rest, enhances the treatment result. So it is one kind of treatment worthy for clinical use.
出处
《现代医院》
2008年第12期55-56,共2页
Modern Hospitals
关键词
血栓闭塞性脉管炎
中西医结合治疗
硬膜外镇痛
辨证论治
Thromboangiitis obliterans, Integrated treatment, Epidural analgesia, Dialectical medicine
