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在使用非甾体抗炎药(NSAID)的基础上额外采用针灸疗法可有效减轻扁桃体切除术后的疼痛。

Additional use of acupuncture to NSAID effectively reduces post-tonsillectomy pain.

作者信息

Sertel Serkan, Herrmann Saskia, Greten Henry Johannes, Haxsen Volker, El-Bitar Samir, Simon Christian Heinrich, Baumann Ingo, Plinkert Peter Karl

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2009 Jun;266(6):919-25. doi: 10.1007/s00405-008-0851-1. Epub 2008 Nov 4.

Abstract

Post-tonsillectomy swallowing pain is a common and distressing side effect after tonsillectomy and thus of great clinical interest. Up until now, there is no randomized controlled patient- and observer-blinded study evaluating the efficacy of acupuncture against swallowing pain after tonsillectomy. We therefore compared the potency of specific verum acupuncture points related to a Chinese medical diagnosis in reducing postoperative swallowing pain with non-specific control points on the body as well as a non-acupuncture group who received standard medication only. The standardized pain therapy after tonsillectomy was orally administered nonsteroidal anti-inflammatory drugs (NSAID) (diclofenac 3 x 50 mg oral). The patients (n = 123) treated with NSAID were asked about their acute pain after taking a sip of water between the first and fifth postoperative day. Participants' pain was assessed using visual analog (VAS) [zero (0) for no pain up to ten (10) for the acute reported outset pain] before and 20 min, 1, 2 and 3 h after acupuncture treatment or standard pain medication, respectively. The functional assessment of diagnosis and treatment point-combination occurred by means of the "Heidelberg Model" of Traditional Chinese Medicine (TCM). Verum acupuncture lead to a significant additional pain relief. In comparison to the acupuncture, they also reported an average of 3 h duration of adequate pain-relief past taking the NSAID. This trial strongly supports a specific acupuncture scheme for the treatment of postoperative swallowing pain after tonsillectomy. It may particularly serve as an alternative pain treatment in case of NSAID intolerances.

摘要

扁桃体切除术后吞咽疼痛是扁桃体切除术后常见且令人痛苦的副作用,因此具有重大的临床研究价值。到目前为止,尚无一项随机对照、患者和观察者双盲的研究评估针刺疗法对扁桃体切除术后吞咽疼痛的疗效。因此,我们比较了与中医诊断相关的特定真穴针刺点、身体上的非特定对照点以及仅接受标准药物治疗的非针刺组在减轻术后吞咽疼痛方面的效果。扁桃体切除术后的标准化疼痛治疗采用口服非甾体抗炎药(NSAID)(双氯芬酸3次,每次50mg口服)。在术后第1天至第5天之间,询问服用NSAID治疗的患者(n = 123)在喝一口水后的急性疼痛情况。分别在针刺治疗或标准疼痛药物治疗前以及治疗后20分钟、1小时、2小时和3小时,使用视觉模拟评分法(VAS)[无痛为零(0),报告的急性初始疼痛为十(10)]评估参与者的疼痛程度。通过中医“海德堡模型”对诊断和治疗穴位组合进行功能评估。真穴针刺显著减轻了额外的疼痛。与针刺组相比,他们在服用NSAID后平均有3小时的充分疼痛缓解期。该试验有力地支持了一种特定的针刺方案用于治疗扁桃体切除术后的吞咽疼痛。在NSAID不耐受的情况下,它尤其可作为一种替代的疼痛治疗方法。

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