摘要
【目的】分析基于开阖枢理论电针治疗臂丛麻醉下肩关节松解术后疼痛的临床疗效。【方法】采用回顾性研究方法,收集2019年12月至2022年9月于山东中医药大学附属医院推拿科病房行臂丛麻醉下肩关节松解术的冻结肩粘连期的50例患者,根据是否采用开阖枢电针治疗将其分为治疗组与对照组,每组各25例。对照组给予氨酚双氢可待因片治疗,治疗组在对照组的基础上,基于开阖枢理论给予董氏奇穴电针治疗,共治疗6 d。观察2组患者治疗前、术后第2天及术后第5天疼痛视觉模拟量表(VAS)评分的变化情况,以及首次追加氨酚双氢可待因的时间与72 h内服用的总片数的情况。比较2组患者治疗前后肩关节活动度(ROM),包括前屈、后伸、外展、内旋、外旋的角度变化情况。并评价2组的安全性及不良反应的发生情况。【结果】(1)治疗后,术后第2天,2组患者的疼痛VAS评分明显改善(P<0.05),但治疗组与对照组比较,差异无统计学意义(P>0.05)。术后第5天,2组患者的疼痛VAS评分明显改善(P<0.05),且治疗组在改善疼痛VAS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗组首次追加镇痛药物时间晚于对照组,差异有统计学意义(P<0.05),且治疗组72 h内镇痛药物的总追加量显著小于对照组,差异有统计学意义(P<0.01)。(3)治疗后,2组患者的肩关节活动度包括前屈、后伸、外展、内旋、外旋的角度均明显改善(P<0.05),且治疗组在改善肩关节活动度方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】基于开阖枢理论电针治疗臂丛麻醉下肩关节松解术后疼痛,能有效缓解患者的临床症状,减少镇痛药物的使用,改善肩关节活动度,不良反应小,疗效显著。
Objective To analyze the clinical efficacy of electroacupuncture for the treatment of postoperative pain after shoulder arthrolysis under brachial plexus anesthesia based on the theory of opening,closing and pivot function.Methods A retrospective study was conducted to collect 50 patients in the frozen shoulder(FS)adhesion phase who underwent shoulder arthrolysis under brachial plexus anaesthesia in the Tuina ward of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from December 2019 to September 2022.The patients were divided into a treatment group and a control group according to whether they were treated with opening,closing and pivot function electroacupuncture,with 25 patients in each group.The patients in the control group were given Paracetamol and Dihydrocodeine Tartrate Tablets,while the patients in the treatment group were treated with DONG’s electroacupuncture based on the theory of opening,closing and pivot function.Both groups were treated for a total of 6 days.Changes in the visual analogue scale(VAS)scores before,on the second and fifth postoperative days,as well as the timing of the first addition of Paracetamol and Dihydrocodeine Tartrate Tablets and the total number of tablets taken within 72 hours were observed in the two groups.The changes in shoulder range of motion(ROM),including the angular changes in forward flexion,back extension,abduction,internal rotation and external rotation were compared before and after treatment in the two groups.The safety and the occurrence of adverse reactions in the two groups were also evaluated.Results(1)After treatment,the VAS scores of patients in the two groups were significantly improved on the second postoperative day(P<0.05),but the difference between the treatment group and the control group was not statistically significant(P>0.05).On the fifth postoperative day,the VAS scores of the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the VAS scores,and the difference was statistically significant(P<0.05).(2)The first additional analgesic drug was added later in the treatment group than in the control group,and the difference was statistically significant(P<0.05).The total amount of additional analgesic drugs added within 72 hours in the treatment group was significantly less than that in the control group,and the difference was statistically significant(P<0.01).(3)After treatment,the ROM of the shoulder joint including the angles of forward flexion,back extension,abduction,internal rotation and external rotation in the two groups were significantly improved(P<0.05),and the treatment group was significantly superior to the control group in improving the mobility of the shoulder joint,and the difference was statistically significant(P<0.05).(4)There was no statistically significant difference in the incidence of adverse reactions between the treatment group and the control group(P>0.05).Conclusion The electroacupuncture based on the theory of opening,closing and pivot function for the treatment of postoperative pain after shoulder arthrolysis under brachial plexus anesthesia can effectively relieve patients’clinical symptoms,reduce the use of analgesic drugs and improve shoulder ROM with minimal adverse effects and significant efficacy.
作者
李苗秀
孙刚毅
井夫杰
刘苗
钟贻凯
LI Miao-Xiu;SUN Gang-Yi;JING Fu-Jie;LIU Miao;ZHONG Yi-Kai(School of Acupuncture and Tuina,Shandong University of Traditional Chinese Medicine,Jinan 250035 Shandong,China;Dept.of Tuina,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014 Shandong,China)
出处
《广州中医药大学学报》
CAS
2023年第9期2269-2274,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
山东省中医药科技发展计划资助项目(编号:2019-0150)。
关键词
开阖枢理论
电针
冻结肩
臂丛麻醉
肩关节松解术
临床观察
the opening,closing and pivot function theory
electroacupuncture
frozen shoulder
brachial plexus anesthesia
shoulder arthrolysis
clinical observation
