电针和耳针联合用于妇科疾病腹部手术后的术后疼痛：一项随机对照试验。

A combination of electroacupuncture and auricular acupuncture for postoperative pain after abdominal surgery for gynaecological diseases: A randomized controlled trial.

机构信息

School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.

Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China.

出版信息

Phytomedicine. 2022 Sep;104:154292. doi: 10.1016/j.phymed.2022.154292. Epub 2022 Jun 27.

DOI:10.1016/j.phymed.2022.154292

PMID:35797863

Abstract

BACKGROUND

Postoperative pain following laparotomy for gynaecological diseases is a common problem that requires effective management to ensure patient satisfaction and recovery. Despite the wide use of acupuncture for pain management, knowledge of its efficacy in managing postoperative pain is limited. Previous literature used either acupuncture or auricular acupuncture alone. However, the combined use of acupuncture and auricular acupuncture have not been studied yet.

PURPOSE

This study examined the efficacy and feasibility of combined electroacupuncture and auricular acupuncture compared to a sham control in reducing pain during 5 days after a laparotomy for gynaecological diseases. This combined therapy was hypothesized to provide greater pain reduction than previous studies with less frequent treatment.

STUDY DESIGN

Randomized sham-controlled, patient- and- assessor-blinded trial.

METHODS

This trial recruited 72 patients scheduled for laparotomy in Hong Kong. Either acupuncture (n = 36) or non-invasive sham acupuncture (n = 36) was performed on the patients preoperatively (1 session) and postoperatively (once a day, up to 6 sessions). The primary outcome was pain at rest, measured using a numerical rating scale from postoperative days 0-5. Secondary outcomes such as analgesics consumption were also assessed. A data and safety monitoring board (DSMB) was established.

RESULTS

All 72 randomized patients were included in the analysis. The acupuncture group had a smaller pain score at rest at 22 hrs (mean = 2.6) than the sham control group (mean = 4.0) (Post hoc intention to treat analysis, Linear regression, mean difference = -1.4, 95% confidence interval = [-0.2] -2.7, p = 0.029). No statistically significant between-group difference was found in other outcomes. No serious adverse event was observed.

CONCLUSION

Perioperative acupuncture treatments are safe and feasible, but the efficacy of acupuncture is inconclusive.

摘要

背景

妇科疾病剖腹手术后的疼痛是一个常见的问题，需要有效的管理以确保患者的满意度和康复。尽管针灸在疼痛管理中被广泛应用，但对于其在管理术后疼痛方面的疗效知之甚少。以前的文献仅使用针灸或耳针单独治疗。然而，针灸和耳针联合使用尚未进行研究。

目的

本研究旨在评估与假对照相比，电针和耳针联合治疗在妇科疾病剖腹手术后 5 天内减轻疼痛的疗效和可行性。与以前的研究相比，这种联合治疗方案假设可以提供更大的疼痛缓解，同时减少治疗的频率。

研究设计

随机、假对照、患者和评估者双盲试验。

方法

本试验招募了在香港接受剖腹手术的 72 名患者。在术前（1 次）和术后（每天 1 次，最多 6 次）对患者进行针灸（n=36）或非侵入性假针灸（n=36）。主要结局是术后 0-5 天的静息时疼痛，使用数字评分量表进行测量。还评估了次要结局，如镇痛药的使用情况。成立了数据和安全监测委员会（DSMB）。