Jiang Yi-Hong, Jiang Wei, Jiang Lei-Ming, Lin Gao-Xiang, Yang Hua, Tan Yi, Xiong Wei-Wei
Department of Anesthesiology, Affiliated Hospital of Guilin Medical College, Guilin 541001, China.
Zhongguo Zhen Jiu. 2010 May;30(5):403-6.
To investigate the effects of acupuncture for preventing and treating the complication after Morphine anesthesia and analgesia and to explore the mechanism of acupuncture treatment.
Patients scheduled to undergo transurethral resection of prostate (TURP) were randomly divided into 3 groups, 20 cases in each group. After lumbar anesthesia, group II and III were treated with acupuncture, and group I with no acupuncture, retaining needle for 30 minutes. Hegu (LI 4), Quchi (LI 11), Neiguan (PC 6), Zhigou (TE 6) were selected in group II, and Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39) and Sanyinjiao (SP 6) selected in group III. The indices of bowel sounds, nausea and vomiting, itching were observed before, during and one day after operation.
After lumbar anesthesia with Morphine, the bowel sounds were significant decrease in all the 3 groups. After acupuncture and before TURP the number of times of bowel sound were increased in group II with significant differences as compared with those in group I and group III at the same time point (all P < 0.05). The incidence rates of vomiting and itching were 5.0% (1/20) and 30.0 (6/20) respectively in group II, which were less than 35.0% (7/20) and 80.0% (16/20) in group I.
Acupuncture has a therapeutic effect on the complication induced by Morphine without nerve block. However, the therapeutic effect of acupuncture is attenuated after nerve block. Its mechanism may be related to nervous pathway.
探讨针刺防治吗啡麻醉镇痛后并发症的效果并探讨其治疗机制。
将拟行经尿道前列腺电切术(TURP)的患者随机分为3组,每组20例。腰麻后,Ⅱ组和Ⅲ组行针刺治疗,Ⅰ组不行针刺,留针30分钟。Ⅱ组选取合谷(LI 4)、曲池(LI 11)、内关(PC 6)、支沟(TE 6),Ⅲ组选取足三里(ST 36)、上巨虚(ST 37)、下巨虚(ST 39)和三阴交(SP 6)。观察手术前、手术中及术后1天的肠鸣音、恶心呕吐、瘙痒等指标。
腰麻联合吗啡后,3组患者的肠鸣音均明显减弱。针刺后,在TURP术前,Ⅱ组肠鸣音次数增加,与Ⅰ组和Ⅲ组在同一时间点相比差异有统计学意义(均P<0.05)。Ⅱ组呕吐和瘙痒发生率分别为5.0%(1/20)和30.0%(6/20),低于Ⅰ组的35.0%(7/20)和80.0%(16/20)。
针刺对吗啡所致并发症有治疗作用,且无需神经阻滞。然而,神经阻滞后针刺的治疗效果减弱。其机制可能与神经通路有关。