1.上海中医药大学附属曙光医院肛肠科(上海 200021)
汤慧丽,女,在读硕士生,住院医师,主要从事中医诊治良性肛肠病的临床研究
韩晔,副主任医师,硕士生导师;E-mail: 18017752552@163.com
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汤慧丽,郑德,王奕韵等.穴位埋线防治混合痔术后疼痛的临床疗效观察[J].上海中医药大学学报,2022,36(04):36-40.
TANG Huili,ZHENG De,WANG Yiyun,et al.Clinical effect of acupoint catgut embedding in the prevention and treatment of postoperative pain of mixed hemorrhoids[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(04):36-40.
汤慧丽,郑德,王奕韵等.穴位埋线防治混合痔术后疼痛的临床疗效观察[J].上海中医药大学学报,2022,36(04):36-40. DOI: 10.16306/j.1008-861x.2022.04.006.
TANG Huili,ZHENG De,WANG Yiyun,et al.Clinical effect of acupoint catgut embedding in the prevention and treatment of postoperative pain of mixed hemorrhoids[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(04):36-40. DOI: 10.16306/j.1008-861x.2022.04.006.
目的,2,观察穴位埋线防治混合痔术后疼痛的临床疗效。,方法,2,纳入96例混合痔患者,随机分为治疗组A(单穴组)、治疗组B(多穴组)和对照组,每组各32例。所有患者均行外剥内扎术治疗,术后予常规镇痛治疗;在上述治疗基础上,治疗组A患者于术前予长强穴埋线治疗,治疗组B患者于术前予长强、白环俞穴埋线治疗。术后第1、3、5、7、14天,采用视觉模拟评分法(VAS)评价患者的平时疼痛及换药疼痛、排便疼痛评分,比较3组患者的术后水肿、出血症状评分;术后当天,评价并比较3组患者的尿潴留评分;比较3组患者的镇痛药物使用率;术后第14天,评价并比较3组患者的镇痛疗效。,结果,2,①术后第3、5、7、14天,治疗组A、治疗组B患者的平时疼痛及换药疼痛、排便疼痛评分均明显低于对照组(,P,<,0.01,,P,<,0.05),但两治疗组间疼痛评分比较,差异无统计学意义(,P,>,0.05)。②术后第5天,治疗组A、治疗组B患者的出血、水肿评分均低于对照组(,P,<,0.05);术后第7天,治疗组A、治疗组B患者的水肿评分亦均低于对照组(,P,<,0.05);术后当天,3组患者的尿潴留评分比较,差异无统计学意义(,P,>,0.05)。③治疗组A、治疗组B患者的镇痛药物使用率明显低于对照组(,P,<,0.05);两治疗组的镇痛药物使用率比较,差异无统计学意义(,P,>,0.05)。④术后第14天,对照组、治疗组A、治疗组B患者的镇痛疗效总有效率分别为90.6%、93.8%、96.9%,治疗组A、治疗组B患者的镇痛疗效优于对照组(,P,<,0.05),但两治疗组的镇痛疗效比较,差异无统计学意义(,P,>,0.05)。,结论,2,穴位埋线防治混合痔术后疼痛疗效显著,并可减轻术后并发症,但单穴埋线与多穴埋线的镇痛疗效无明显差异。
Objective: To observe the clinical efficacy of acupoint catgut embedding in the prevention and treatment of postoperative pain of mixed hemorrhoids.,Methods,2,A total of 96 patients with mixed hemorrhoids were included and randomly divided into the treatment group A (single acupoint group), treatment group B (multiple acupoint group) and control group, 32 cases in each group. All patients were treated with Milligan-Morgan hemorrhoidectomy and postoperative routine analgesia. Based on above treatment, the patients in the treatment group A were treated with catgut embedding at acupoint Changqiang (DU1) before operation, and the patients in the treatment group B were treated with catgut embedding at acupoints Changqiang (DU1) and Baihuanshu (BL30) before operation. On the 1st, 3rd, 5th, 7th and 14th days after operation, the visual analogue scale (VAS) was used to evaluate the usual pain, dressing change pain and defecation pain scores, and the scores of postoperative edema and bleeding symptoms of the three groups were compared. On the postoperative day, the urinary retention scores of the three groups were evaluated and compared. The use rate of analgesic drugs of the three groups was compared. On the 14th day after operation, the analgesic effects of the three groups were evaluated and compared.,Results,2,①On the 3rd, 5th, 7th and 14th days after operation, the scores of usual pain, dressing change pain and defecation pain in the treatment groups A and B were significantly lower than those in the control group (,P,<,0.01, ,P,<,0.05), but there was no statistical difference in the pain scores between the two treatment groups (,P,>,0.05). ②On the 5th day after operation, the scores of bleeding and edema in the treatment groups A and B were lower than those in the control group (,P,<,0.05). On the 7th day after operation, the edema scores in the treatment groups A and B were also lower than those in the control group (,P,<,0.05). On the postoperative day, there was no statistical difference in the urinary retention scores among the three groups (,P,>,0.05). ③The use rate of analgesic drugs in the treatment groups A and B was significantly lower than that in the control group (,P,<,0.05). There was no statistical difference in the use rate of analgesic drugs between the two treatment groups (,P,>,0.05). ④On the 14th day after operation, the total effective rates of analgesia in the control group, treatment group A and treatment group B were 90.6%, 93.8% and 96.9% respectively. The analgesic efficacy of the treatment group A and treatment group B was better than that of the control group (,P,<,0.05), but there was no statistical difference in analgesic efficacy between the two treatment groups (,P,>,0.05).,Conclusion,2,Acupoint catgut embedding has significant effect in the prevention and treatment of postoperative pain of mixed hemorrhoids, which can reduce the postoperative complications, but there is no significant difference in the analgesic effect between single acupoint and multiple acupoint catgut embedding.
混合痔术后疼痛穴位埋线超前镇痛
mixed hemorrhoidspostoperative painacupoint catgut embeddingpreemptive analgesia
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