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[针刺麻醉的祛魅]

[Demythification of acupunctural anesthesia].

作者信息

Huguenard P

出版信息

Ann Anesthesiol Fr. 1975 Oct;16(6):397-415.

PMID:2056
Abstract

The so-called method of acupuncture anesthesia uses a series of techniques: selection of patients, psychotherapy, premedication, adjuvants (morphinomimetics, local anesthetics), choice of points (very varied) whose specificity has not been demonstrated, mechanical or electrical stimulation (with very differents depending on the "schools". The effects of these procedures are inconstant. They are slowly established. At best, they are manifested by a hypo-esthesia which is more or less wide-spread and is not accompanied by any "anti-reflex" protection. The action of the organism's different functions is not known in detail. There are no statistical studies in the strict sense of the term, in man. It can be roughly estimated that out of 100 surgical patients chosen, about 30 undergo the intervention in acceptable conditions in the western world. The cases, although nothing is concealed in Hanoï as well as in Peking, are difficult, and should only be handled by experienced anesthetists-resuscitators, with knowledge of acupuncture. Certain of the method's advantages only appear in comparison with bad "chemical" anesthesia (atoxicity, simplicity, economy), others are practically investions (anallergic effects, anti-infections, anti-shock) or at least abuse of language. The disadvantages apart from the inconstancy of effectiveness, the absence of "protection", the duration of induction, consist of lack of standardization of techniques, difficulties of animal experiments and the lack of rational explanation of the mechanism of action.

摘要

所谓的针刺麻醉方法运用了一系列技术

患者选择、心理治疗、术前用药、辅助药物(类吗啡药、局部麻醉药)、穴位选择(种类繁多且其特异性未得到证实)、机械或电刺激(因“流派”不同而差异很大)。这些操作的效果并不稳定,起效缓慢。充其量表现为或多或少广泛存在的感觉减退,且不伴有任何“抗反射”保护。机体不同功能的作用尚不清楚。严格来说,在人体上没有相关的统计学研究。大致估计,在100名接受手术的患者中,在西方大约30人能在可接受的条件下进行手术。尽管在河内和北京都没有隐瞒这些病例,但手术难度较大,应该仅由有经验且了解针灸的麻醉复苏医生来操作。该方法的某些优点仅在与不良的“化学”麻醉相比时才显现出来(无毒性、操作简单、经济),其他优点实际上是虚构的(无过敏反应、抗感染、抗休克),或者至少是滥用术语。除了效果不稳定、缺乏“保护”、诱导时间长之外,其缺点还包括技术缺乏标准化、动物实验困难以及对作用机制缺乏合理的解释。

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