摘要
目的探讨电针用于膝关节置换术后病人的镇痛作用及对血清前列腺素E_(2)(PGE_(2))及β-内啡肽的影响。方法选取哈尔滨医科大学附属第一医院2017年3月至2019年3月哈尔滨医科大学附属第一医院收治的90例行全膝关节置换术病人,采用随机数字表法分为对照组与电针组,每组45例。对照组于术后采取药物镇痛,电针组在术前3 d至术后5 d采用电针进行镇痛。比较两组病人术后不同时相点的活动痛视觉模拟评分法(VAS)评分与静息痛VAS评分、膝关节主动活动度与被动活动度、术前3 d与术后第7天的血清PGE_(2)、β-内啡肽、不良反应发生率。结果两组术后12 h的静息痛VAS评分与活动痛VAS评分、膝关节主动活动度与被动活动度的差异无统计学意义(P>0.05)。电针组术后24 h、48 h、120 h的静息痛VAS评分[(5.44±1.08)分比(6.12±1.04)分,(4.26±1.02)分比(5.57±1.15)分,(2.21±0.43)分比(3.37±0.32)分]与活动痛VAS评分[(5.44±1.08)分比(6.41±1.02)分,(4.59±1.07)分比(5.82±1.16)分,(2.43±0.51)分比(3.42±0.41)分]均低于对照组,膝关节主动活动度与被动活动度均高于对照组(P<0.05)。术前3 d,两组病人血清PGE_(2)与β-内啡肽水平水平相近(P>0.05);术后第7天,两组PGE_(2)水平均明显下降,β-内啡肽明显升高(P<0.05)。术后第7天,电针组PGE_(2)[(173.23±11.92)pg/mL比(207.11±12.17)pg/mL]低于对照组,β-内啡肽[(289.23±11.52)pg/mL比(237.11±12.40)pg/mL]高于对照组(P<0.05)。电针组术后不良反应发生率低于对照组(4.44%比20.00%,P<0.05)。结论电针可有效下调血清PGE_(2)并上调β-内啡肽发挥更理想的术后镇痛效果,促进病人术后膝关节活动度的更快恢复,且安全性更高。
Objective To investigate the analgesic effect of electroacupuncture on knee replacement and its effect on serum prostaglandin E_(2)(PGE_(2))andβ-endorphin.Methods Ninety patients undergoing total knee arthroplasty admitted to The First Affiliated Hospital of Harbin Medical University from March 2017 to March 2019 were selected and assigned into control group and electroacupuncture group by random number table method,with 45 cases in each group.The control group received medication for analgesia after the operation,and the electroacupuncture group received electroacupuncture for analgesia from 3 days before the operation to 5 days after the operation.The active pain visual analogue score(VAS)and resting pain VAS score,active and passive knee ranges of motion at different time points after the operation,serum PGE_(2) andβ-endorphin levels 3 days before operation and 7 days after operation,incidence of adverse reactions were compared between the two groups.Results There were no significant differences in active pain and resting pain VAS scores,active and passive knee ranges of motion between the two groups at 12 h after operation(P>0.05).The resting pain VAS scores of 24 h,48 h,120 h after operation in the electroacupuncture group[(5.44±1.08)points vs(6.12±1.04)points,(4.26±1.02)points(5.57±1.15)points,(2.21±0.43)points vs(3.37±0.32)points]and active pain VAS scores[(5.44±1.08)points vs(6.41±1.02)points,(4.59±1.07)points(5.82±1.16)points,(2.43±0.51)points(3.42±0.41)points]were lower than those in the control group,and the active and passive knee ranges of motion in the electroacupuncture group were higher than those in the control group(P<0.05).The serum PGE_(2) andβ-endorphin levels of the two groups of patients were similar at 3 days before the operation(P>0.05).On the 7 th day after operation,the PGE_(2) levels were significantly decreased,andβ-endorphin were significantly increased in both groups(P<0.05).On the 7 th day after operation,the PGE_(2)[(173.23±11.92)pg/mL vs.(207.11±12.17)pg/mL]was
作者
毛原夫
王文波
姜泽宇
聂磊
刘子文
MAO Yuanfu;WANG Wenbo;JIANG Zeyu;NIE Lei;LIU Ziwen(The Third Department of Orthopedics,The First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150000,China)
出处
《安徽医药》
CAS
2021年第10期1977-1981,共5页
Anhui Medical and Pharmaceutical Journal
基金
黑龙江省卫生厅科研课题(2012230)。
