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针刺疗法作为儿科急诊科疼痛的非药物治疗方法

Acupuncture as a Nonpharmacologic Treatment for Pain in a Pediatric Emergency Department.

作者信息

Tsai Shiu-Lin, Reynoso Elena, Shin Da Wi, Tsung James W

机构信息

From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine.

Division of Gastroenterology, Department of Pediatrics, Columbia University College of Physicians and Surgeons.

出版信息

Pediatr Emerg Care. 2021 Jul 1;37(7):e360-e366. doi: 10.1097/PEC.0000000000001619.

Abstract

OBJECTIVES

With epidemic opioid deaths and abuse in the United States, government agencies recommend nonpharmacological treatments for pain. However nonopioid treatment options for moderate to severe pain in the pediatric emergency department (PED) are limited. Acupuncture has been shown to be effective for pain. The objective of this study was to evaluate the feasibility of using traditional acupuncture (TA) and battlefield acupuncture (BFA) in the treatment of pain in the PED.

METHODS

A pediatric cohort treated with acupuncture for pain in an urban PED was assessed. All subjects received TA or BFA as treatment, and pre/postacupuncture pain scores, feedback, and adverse events were assessed. The primary outcome was a change in pain score.

RESULTS

Twelve patients received BFA, and 13 received TA for these pain conditions: headaches, sciatica, paraphimosis, torticollis, joint pains (knee, shoulder, jaw), sprains (foot, wrist, thumb), dysmenorrhea, otitis externa, sickle cell, and muscle knot. The mean ± SD pain score change, 5.8 ± 2.5 (P < 0.05; 95% confidence interval, 4.9-7.0), was clinically and statistically significant. Over 90% of subjects reported significant improvement or resolution of pain; 96% were satisfied with pain relief and would receive acupuncture again. Two adverse events were noted: one patient reported dizziness, and another, a tinge of blood at 1 of 90 needled points.

CONCLUSIONS

This study suggests that acupuncture is a potential nonpharmacologic therapeutic option for acute pain management in the PED.

摘要

目的

鉴于美国阿片类药物导致的流行死亡和滥用情况,政府机构推荐采用非药物疗法治疗疼痛。然而,儿科急诊科(PED)中用于治疗中度至重度疼痛的非阿片类治疗选择有限。针灸已被证明对疼痛有效。本研究的目的是评估传统针灸(TA)和战场针灸(BFA)在PED中治疗疼痛的可行性。

方法

对在城市PED接受针灸治疗疼痛的儿科队列进行评估。所有受试者均接受TA或BFA治疗,并评估针灸前后的疼痛评分、反馈及不良事件。主要结局是疼痛评分的变化。

结果

12例患者接受BFA治疗,13例接受TA治疗,涉及的疼痛病症包括:头痛、坐骨神经痛、阴茎头包皮炎、斜颈、关节疼痛(膝盖、肩膀、下巴)、扭伤(足部、手腕、拇指)、痛经、外耳道炎、镰状细胞病和肌肉结节。平均疼痛评分变化为5.8±2.5(P<0.05;95%置信区间,4.9 - 7.0),在临床和统计学上均具有显著意义。超过90%的受试者报告疼痛有显著改善或缓解;96%的受试者对疼痛缓解满意,并愿意再次接受针灸治疗。记录到两起不良事件:一名患者报告头晕,另一名患者在90个针刺点中的1个出现轻微出血。

结论

本研究表明,针灸是PED急性疼痛管理中一种潜在的非药物治疗选择。

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