Dingemann J, Plewig B, Baumann I, Plinkert P K, Sertel S
Department of Otorhinolaryngology, Head & Neck Surgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
HNO. 2017 Jan;65(Suppl 1):73-79. doi: 10.1007/s00106-016-0289-5.
Postoperative swallowing pain is one of the most unpleasant after-effects of tonsillectomy. During recent years, the demand for alternatives to drug-based pain therapy has continued to grow, although the topic has received little research attention until now.
A total of 46 patients were randomized into verum acupuncture, control acupuncture, and drug-based treatment groups. All patients received nonsteroidal antirheumatic drugs (NSAIDs). One hour after drug intake, the verum group also received acupuncture according to classical acupuncture rules (S34, S44 and PC5). The control group had acupuncture needles placed at nonspecific acupuncture points in the midaxillary line. Acupuncture was performed by a blinded acupuncturist, who had learnt exclusively these techniques in the run up to the study. Patients were asked to evaluate their pain before, and at intervals of 20 min, 1 h, 2 h, and 3 h after drug intake/acupuncture treatment using a visual analog scale (VAS).
The analgesic effect of acupuncture was significant up to 3 hours in the verum group (p < 0.05). The analgesic effect in the control acupuncture group was significant for up to 1 h after acupuncture (p < 0.05). With reference to the time point before acupuncture, the differences between both acupuncture groups and the drug group were significant (p < 0.01) over the whole time.
Acupuncture is an effective complement to NSAIDs in the treatment of posttonsillectomy pain. Particularly patients with allergies, drug intolerance, or reduced response to the commonly administered drugs may benefit from acupuncture.
术后吞咽疼痛是扁桃体切除术后最令人不适的后遗症之一。近年来，尽管该话题迄今为止很少受到研究关注，但对基于药物的疼痛治疗替代方法的需求持续增长。
总共46例患者被随机分为真穴针刺组、对照针刺组和药物治疗组。所有患者均接受非甾体类抗风湿药（NSAIDs）。服药1小时后，真穴组还根据经典针刺规则（S34、S44和PC5）接受针刺。对照组在腋中线非特异性穴位放置针灸针。针刺由一名盲法针灸师进行，该针灸师在研究前专门学习了这些技术。要求患者在服药/针刺治疗前以及服药/针刺治疗后20分钟、1小时、2小时和3小时每隔一段时间使用视觉模拟量表（VAS）评估疼痛程度。
真穴组针刺的镇痛效果在3小时内显著（p < 0.05）。对照针刺组针刺后的镇痛效果在1小时内显著（p < 0.05）。与针刺前的时间点相比，两个针刺组与药物组在整个时间段内的差异均显著（p < 0.01）。
针刺是NSAIDs治疗扁桃体切除术后疼痛的有效补充。特别是对常见药物过敏、不耐受或反应降低的患者可能从针刺中获益。
