Zhang Xingshuo, Chen Hao, Li Jingqiao, Liu Xingang, Wang Xuesong, Xue Pingju, Lin Miao, Li Jidong, She Yanfen
School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang, China.
West Medical Center in Shijiazhuang, Shijiazhuang, China.
Front Neurol. 2024 Feb 16;15:1275192. doi: 10.3389/fneur.2024.1275192. eCollection 2024.
This study aimed to evaluate the effectiveness and safety of auricular acupuncture (AA) on postoperative analgesia, the degree of postoperative nausea, and the effect of inflammation after total knee arthroplasty (TKA).
This was a single-center, placebo-controlled, randomized clinical trial. In total, 96 patients were randomly divided into an AA group with an indwelling intradermal needle ( = 48) and a sham auricular acupuncture (SAA) group with a non-penetrating placebo needle ( = 48). Intra-spinal anesthesia was adopted in both groups during surgery, and an epidural analgesic pump was implanted after surgery for 48 h. The primary outcome was the post-surgery visual analog score (VAS) of resting and movement states (at 6, 12 h and 1, 2, 3, 5, and 7 days). The secondary outcomes included additional doses of analgesic injection during the treatment, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count on the 1st, 3rd, and 7th day after the operation, nausea on the 1st, 2nd, and 3rd day after the operation, the Hospital for Special Surgery Knee Score (HSS) on the 2nd and 12th week after the operation, and adverse events.
The VAS in the AA group at 6 h, 12 h, 2, 3, and 5 days after surgery were lower than those of the SAA group ( < 0.05). Among the secondary outcomes, the total dose of additional analgesic injection after surgery in the AA group was lower than that in the SAA group ( < 0.05). The serum CRP on the 1st day after operation in the AA group was lower than that in the SAA group ( < 0.05). The degree of nausea on 2nd day after surgery in the AA group was lower than that in the SAA group ( < 0.05). There was no significant difference in other outcomes ( > 0.05).
In this study, AA was shown to be an effective and safe complementary and alternative therapy for pain relief after TKA, which was able to reduce the total postoperative dose of additional painkillers, decrease serum CRP 1 day after surgery, and improve the degree of postoperative nausea.
www.chictr.org.cn, ChiCTR2100054403.
本研究旨在评估耳针疗法（AA）对全膝关节置换术（TKA）术后镇痛、术后恶心程度及炎症反应的有效性和安全性。
这是一项单中心、安慰剂对照、随机临床试验。总共96例患者被随机分为耳针组（皮内留置针，n = 48）和假耳针组（非穿透性安慰剂针，n = 48）。两组手术期间均采用脊髓内麻醉，术后植入硬膜外镇痛泵48小时。主要结局指标为术后静息和活动状态下的视觉模拟评分（VAS）（术后6、12小时及1、2、3、5、7天）。次要结局指标包括治疗期间额外镇痛注射剂量、术后第1、3、7天的C反应蛋白（CRP）水平、红细胞沉降率（ESR）和白细胞（WBC）计数、术后第1、2、3天的恶心程度、术后第2周和第12周的特殊外科医院膝关节评分（HSS）以及不良事件。
耳针组术后6小时、12小时、2、3和5天的VAS低于假耳针组（P < 0.05）。在次要结局指标中，耳针组术后额外镇痛注射的总剂量低于假耳针组（P < 0.05）。耳针组术后第1天的血清CRP低于假耳针组（P < 0.05）。耳针组术后第2天的恶心程度低于假耳针组（P < 0.05）。其他结局指标无显著差异（P > 0.05）。
在本研究中，耳针疗法被证明是TKA术后缓解疼痛的一种有效且安全的补充和替代疗法，它能够减少术后额外止痛药的总剂量，降低术后第1天的血清CRP水平，并改善术后恶心程度。
