Ho Hsin-Yi, Chen Chao-Wei, Li Ming-Chieh, Hsu Yu-Pao, Kang Shih-Ching, Liu Erh-Hao, Lee Ko-Hung
Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan.
Biomed J. 2014 May-Jun;37(3):147-55. doi: 10.4103/2319-4170.117895.
Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures.
A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI) needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI) lung volumes and sleep quality were assessed.
The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p < 0.05), and the effect persisted for at least 6 h in most patients. Sustained maximal inspiration lung volumes and sleep quality did not show improvement through every acupuncture intervention, and they could not respond accurately to pain relief via acupuncture.
The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.
由于镇痛对肋骨骨折患者的剧痛缓解有限，疼痛控制已被从业者和住院患者视为优先事项。本研究进行了一项前瞻性随机对照试验，以分析针刺疗法缓解肋骨骨折住院患者急性疼痛的疗效和效率。
共招募58名住院患者并分为两组，分别接受相同剂量的常规口服镇痛药，同时治疗组接受毫针针刺治疗，对照组接受皮肤表面放置的揿针治疗，均通过新型针刺方式每天治疗1次，连续治疗3天。在诱发疼痛的活动期间评估疼痛缓解效果，并评估持续最大吸气（SMI）肺容量和睡眠质量。
在深呼吸、咳嗽和翻身过程中，毫针治疗组患者的疼痛缓解效果优于揿针组（p<0.05），且在大多数患者中，这种效果持续至少6小时。每次针刺干预后，持续最大吸气肺容量和睡眠质量均未改善，且无法准确反映针刺缓解疼痛的效果。
主动评估可为评估肋骨骨折引起的疼痛强度提供更合适的模型。这种针刺部位对应疼痛点的新型针刺方式，可作为缓解肋骨骨折住院患者疼痛的一种安全可行的治疗方法。
