Shokrani Omid, Saghaei Mahmood, Ashrafi Farzaneh, Sadeghi Alireza
General Physician, Division of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Anesthesia, Division of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2014 May 28;3:125. doi: 10.4103/2277-9175.133206. eCollection 2014.
Bone marrow aspiration and biopsy (BMA/BMB) is a painful procedure mostly used in diagnosing and staging of a broad spectrum of hematological diseases. In spite of local anesthesia, the prevalence and intensity of the pain and patient discomfort caused by this procedure are considerable. The effect of acupuncture and electrical stimulation of acupoints (acupuncture points) in the treatment of many medical conditions, including pain, have been approved. The study is designed to evaluate the effect of electrical stimulation of acupoints to decrease the pain during BMA/BMB in adults.
In a double-blind controlled clinical trial, 50 patients undergoing BMA/BMB were randomly allocated into two groups, to receive either true or placebo electrical stimulation of acupoints LI-4 (large intestine 4, Hegu) and LI-11 (large intestine 11, Quchi), bilaterally. Both groups received infiltrative local anesthesia. The pain level caused by BMA/BMB was measured using the Visual Analog Scale (VAS).
The means of the VAS in the case and control groups were 41.84 ± 20.54 and 69.40 ± 20.06 respectively (P < 0.001). The systolic and diastolic blood pressure and pulse rate rose significantly in both the groups compared to the basal values. The rise was lower in the acupuncture group compared to the placebo group regarding systolic blood pressure and pulse rate (P = 0.018 and P < 0.001, respectively).
The results of this study show that the electrical stimulation of acupoints significantly decreases the pain caused by BMA/BMB and some of the complications of the pain.
骨髓穿刺和活检（BMA/BMB）是一种痛苦的操作，主要用于多种血液系统疾病的诊断和分期。尽管采用了局部麻醉，但该操作引起的疼痛发生率和强度以及患者的不适感仍相当可观。针刺和穴位电刺激在包括疼痛在内的多种医疗状况治疗中的效果已得到认可。本研究旨在评估穴位电刺激对减轻成人BMA/BMB过程中疼痛的效果。
在一项双盲对照临床试验中，50例接受BMA/BMB的患者被随机分为两组，分别接受双侧合谷穴（LI-4）和曲池穴（LI-11）的真电刺激或安慰剂电刺激。两组均接受浸润性局部麻醉。采用视觉模拟量表（VAS）测量BMA/BMB引起的疼痛程度。
病例组和对照组的VAS均值分别为41.84±20.54和69.40±20.06（P<0.001）。与基础值相比，两组的收缩压、舒张压和脉搏率均显著升高。针刺组的收缩压和脉搏率升高幅度低于安慰剂组（分别为P=0.018和P<0.001）。
本研究结果表明，穴位电刺激可显著减轻BMA/BMB引起的疼痛及一些疼痛相关并发症。
