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[电针对全膝关节置换术患者辅助镇痛及血清β-内啡肽和前列腺素E水平的影响]

[Effect of electroacupunture on supplementary analgesia and the levels of serum β-endorphin and prostaglandin E in patients with total knee arthroplasty].

作者信息

Chen Da, Sheng Dong, Xu Jing-Li, Zhang Yang-Yue, Lin Tian-Ye, Zhang Qing-Wen

机构信息

the First Hospital Affiliated to Guangzhou University of CM, Guangzhou 510000, Guangdong Province, China.

Department of Orthopaedics, Chongqing Orthopedics Hospital of TCM.

出版信息

Zhongguo Zhen Jiu. 2019 Mar 12;39(3):247-50. doi: 10.13703/j.0255-2930.2019.03.006.

Abstract

OBJECTIVE

To observe the effect on supplementary analgesia after total knee arthroplasty (TKA) treated with electroacupunture, and explore it's mechanism.

METHODS

A total of 40 patients with severe knee osteoarthritis were randomized into an observation group and a control group, 20 cases in each one. During the operation, patients were given epidural anesthesia in the two groups, conventional patient controlled epidural analgesia and oral celecoxib were applied after the operation. In the observation group, electroacupunture was used at Liangqiu (ST 34), Xuehai (SP 10), Yinlingquan (SP 9), Zusanli (ST 36), Fenglong (ST 40) and Qiuxu (GB 40) on the operation side from the 1st to 7th day after the operation to support analgesia, 30 min for each time, once a day. The visual analogue scale (VAS) was used to record postoperative pain of resting state and active state. The levels of serum prostaglandin E and β-endorphin were measured on the 1st and 7th day after surgery in the two groups.

RESULTS

In the observation group, the VAS scores of resting state and active state were superior to the control group on the 3rd, 5th and 7th day after the operaton (all <0.05); after the treatment, the level of serum β-endorphin was increased and the level of serum prostaglandin E was reduced in the two groups (all <0.05), and the change of the observation group was larger than that of the control group (both <0.05).

CONCLUSION

Electroacupunture has the effect of supplementary analgesia for patients after TKA, the mechanism may be related to promote the synthesis of β-endorphin and inhibit the synthesis of prostaglandin E.

摘要

目的

观察电针治疗对全膝关节置换术(TKA)后辅助镇痛的效果,并探讨其作用机制。

方法

将40例重度膝关节骨关节炎患者随机分为观察组和对照组,每组20例。两组患者均在手术中给予硬膜外麻醉,术后采用常规患者自控硬膜外镇痛及口服塞来昔布。观察组于术后第1天至第7天对手术侧梁丘(ST34)、血海(SP10)、阴陵泉(SP9)、足三里(ST36)、丰隆(ST40)和丘墟(GB40)进行电针治疗以辅助镇痛,每次30分钟,每天1次。采用视觉模拟评分法(VAS)记录术后静息状态和活动状态下的疼痛情况。于术后第1天和第7天测量两组患者血清前列腺素E和β-内啡肽水平。

结果

观察组术后第3天、第5天和第7天静息状态和活动状态下的VAS评分均优于对照组(均P<0.05);治疗后,两组患者血清β-内啡肽水平升高,血清前列腺素E水平降低(均P<0.05),且观察组变化幅度大于对照组(均P<0.05)。

结论

电针治疗对TKA术后患者有辅助镇痛作用,其机制可能与促进β-内啡肽合成及抑制前列腺素E合成有关。

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