腕踝针用于痔术后镇痛的临床疗效及对炎症因子水平的影响

Clinical Efficacy of Wrist and Ankle Acupuncture in Postoperative Analgesia for Hemorrhoids and Its Influence on Levels of Inflammatory Factors

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摘要目的:基于多模式、分阶梯镇痛理论,探讨腕踝针用于痔术后镇痛的临床疗效及对炎症因子水平的影响。方法:选择2023年2月至2024年1月,本院及协作单位治疗的240例痔术后疼痛患者,根据疼痛评分分为轻度疼痛组60例、中度疼痛组90例和重度疼痛组90例。轻度疼痛组再随机分为腕踝针组(腕踝针治疗)和空白对照组(不予镇痛治疗),每组30例;中度疼痛疼痛随机分为腕踝针组(腕踝针治疗)、药物组(氨酚双氢可待因片20mg口服)和联合组(腕踝针联合氨酚双氢可待因片口服),每组30例;重度疼痛组随机分为腕踝针组(腕踝针治疗)、注射组(盐酸哌替啶针100mg肌注)和联合组(腕踝针联合盐酸哌替啶针肌注),每组各30例。比较3组疼痛情况和血清中炎症因子水平。结果:干预30min后,轻度疼痛患者腕踝针组镇痛效果、镇痛时间和炎症因子水平均优于空白对照组(P<0.05),中度疼痛患者联合组镇痛效果、镇痛时间和炎症因子水平均优于腕踝针组和药物组(P<0.05),重度疼痛患者联合组镇痛效果、镇痛时间和炎症因子水平均优于注射组和腕踝针组(P<0.05)。结论:腕踝针对痔术后疼痛有明确的镇痛效果,对轻中度疼痛效果最佳,对重度疼痛腕踝针联合镇痛药物能明显增强疗效、降低毒副作用,其分子生物学机制可能与提高TNF-α、IL-6、COX-2和PGE2水平,增加痛感阈值有关。 Objective To explore the clinical efficacy of wrist and ankle acupuncture in postoperative an-algesia for hemorrhoids and its influence on the levels of inflammatory factors based on the theory of multi-mode and step analgesia.Methods From February 2023 to January 2024,total 240 patients with hemor-rhoidal postoperative pain treated in our hospital and cooperating units were selected and divided into mild pain group with 60 patients,moderate pain group with 90 patients and severe pain group with 90 patients according to their pain scores.The mild pain group was randomly divided into the wrist and ankle acupunc-ture group(wrist and ankle acupuncture treatment)and the blank control group(no analgesic treatment),with 30 cases in each group.The moderate pain group was randomly divided into wrist and ankle acupunc-ture group(wrist and ankle acupuncture treatment),drug group(oral administration of 20 mg acetamino-phen dihydrocodeine tablet)and combined group(wrist and ankle acupuncture combined with oral admin-istration of acetaminophen dihydrocodeine tablet),with 30 cases in each group.The severe pain group was randomly divided into wrist and ankle acupuncture group(wrist and ankle acupuncture treatment),injec-tion group(intramuscular injection of 100 mg pethidine hydrochloride)and combination group(wrist and ankle acupuncture combined with intramuscular injection of pethidine hydrochloride),with 30 cases in each group.Pain and serum levels of inflammatory factors were compared between the three groups.Results After 30 min of intervention,the analgesic effect,analgesic time and inflammatory factor levels of the wrist and ankle acupuncture group in patients with mild pain were better than those in the blank control group(P<0.05).The analgesic effect,analgesic time and inflammatory factor levels of the combined group in patients with moderate pain were better than those in the wrist and ankle acupuncture group and drug group(P<0.05).The analgesic effect,analgesic time and inflammatory factor levels of the combined group

作者罗林山张威巩跃生魏淑娥 LUO Lin-shan;ZHANG Wei;GONG Yue-sheng;WEI Shu-e(Zhengzhou Hospital of Colorectal and Anal Diseases/Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou,Henan450004)

机构地区郑州市大肠肛门病医院/河南省中医消化病医院

出处《中国肛肠病杂志》 2024年第6期21-24,共4页 Chinese Journal of Coloproctology

基金 2024年度河南省科技攻关项目(242102310560) 郑州市大肠肛门病医院2024年度院内课题(2024-YNKY-01)。

关键词痔术后疼痛腕踝针炎症因子水平疗效 Hemorrhoidal postoperative pain Wrist and ankle acupuncture Levels of inflammatory fac-tors Efficacy

分类号 R246.2 [医药卫生—针灸推拿学]