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重症监护病房中针刺疗法治疗疼痛和恶心:在一家公共安全网医院开展的可行性研究

Acupuncture for Pain and Nausea in the Intensive Care Unit: A Feasibility Study in a Public Safety Net Hospital.

作者信息

Feeney Colin, Bruns Elizabeth, LeCompte Gabrielle, Forati Anahita, Chen Thomas, Matecki Amy

机构信息

1 Department of Internal Medicine, Highland General Hospital , Oakland, CA.

2 UC Berkeley-UC San Francisco Joint Medical Program , Berkeley, CA.

出版信息

J Altern Complement Med. 2017 Dec;23(12):996-1004. doi: 10.1089/acm.2016.0323. Epub 2017 Apr 25.

DOI:10.1089/acm.2016.0323
PMID:28440663
Abstract

OBJECTIVES

To explore the feasibility and acceptability of providing acupuncture treatment to relieve pain and nausea symptoms in intensive care unit (ICU) patients.

DESIGN

Prospective feasibility study.

SETTINGS/LOCATION: Public safety net hospital with a 20-bed mixed medical/surgical ICU.

SUBJECTS

Patients from all services admitted to the ICU from November 14, 2014 to April 2015.

INTERVENTIONS

Three 20 min acupuncture treatments given for consented patients who were experiencing pain and/or nausea, in addition to usual care.

OUTCOME MEASURES

Primary outcomes assessed were the proportion of patients offered acupuncture who accepted it, their perceptions of the effects of acupuncture treatment on pain and nausea, and the incidence of adverse effects related to acupuncture. Secondary outcomes included medication use, ICU and hospital length of stay, and frequency and pattern of Traditional Chinese Medicine (TCM) diagnoses.

RESULTS

Of the 576 patients admitted to the ICU, 32.2% were deemed eligible for acupuncture and 42% of these (8% of total) received it. Self-reported pain level immediately after treatment decreased from the pain score reported immediately before treatment by 2.36 points. The majority of patients reported a benefit from acupuncture on symptoms of pain and also an anxiolytic effect. No major adverse effects were reported. There was a significant decrease in morphine usage after each treatment. The most common single TCM diagnosis was Qi and blood stagnation.

CONCLUSIONS

Acupuncture is feasible, safe, and acceptable in an ICU setting by patients from diverse backgrounds.

摘要

目的

探讨在重症监护病房(ICU)为患者提供针灸治疗以缓解疼痛和恶心症状的可行性和可接受性。

设计

前瞻性可行性研究。

地点

拥有20张床位的内科/外科混合ICU的公共安全网医院。

研究对象

2014年11月14日至2015年4月入住ICU的所有科室的患者。

干预措施

除常规护理外,为同意接受治疗且有疼痛和/或恶心症状的患者进行三次每次20分钟的针灸治疗。

观察指标

主要观察指标包括接受针灸治疗的患者比例、他们对针灸治疗疼痛和恶心效果的看法以及与针灸相关的不良反应发生率。次要观察指标包括药物使用情况、ICU住院时间和住院时间、中医(TCM)诊断的频率和模式。

结果

在576名入住ICU的患者中,32.2%被认为适合接受针灸治疗,其中42%(占总数的8%)接受了治疗。治疗后立即自我报告的疼痛程度较治疗前立即报告的疼痛评分降低了2.36分。大多数患者报告针灸对疼痛症状有改善作用,还有抗焦虑效果。未报告重大不良反应。每次治疗后吗啡用量显著减少。最常见的单一中医诊断是气滞血瘀。

结论

针灸在ICU环境中对不同背景的患者是可行、安全且可接受的。

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