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耳穴按压治疗肛周脓肿患者术后疼痛和焦虑的效果观察

Auricular point acupressure for managing postoperative pain and reducing anxiety in patients with perianal abscesses.

机构信息

Department of Chinese Medicine, Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong 226001, PR China; Nanjing University of Chinese Medicine, Nanjing 210023, PR China.

Department of Chinese Medicine, Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong 226001, PR China.

出版信息

Explore (NY). 2024 Sep-Oct;20(5):103020. doi: 10.1016/j.explore.2024.103020. Epub 2024 Jun 22.

Abstract

OBJECTIVE

The objective of this study is to assess the efficacy of auricular point acupressure in relieving postoperative pain and reducing anxiety among patients with perianal abscesses.

METHODS

We included 61 patients with perianal abscesses who were admitted to the Nantong First People's Hospital between July 2019 and June 2020 and were scheduled to undergo one-stage radical surgery. We divided them into the treatment group (n = 31), where patients were administered preoperative auricular acupressure targeting the bilateral Shenmen, subcortical, and other points. They were instructed to apply pressure five to six times per day, each time for about 3-5 min. Patients in the control group (n = 30) received routine preoperative preparation. The treatment duration for both groups was one week. We compared the two groups using the pain visual analog scale (VAS) scores, the use of additional postoperative analgesics, and scores on the Hamilton anxiety and depression scales pre- and post-surgery at 6 h, 24 h, 48 h, 72 h, and 1 week after surgery, as well as at the time of the first bowel movement.

RESULTS

Patients in the treatment group reported lower VAS scores than those of the control group at 48 h, 72 h, 1 week, and at the first defecation post-surgery, and the differences were statistically significant (all P < 0.05). Additional postoperative analgesics were used in seven patients in the treatment group (22.58 %) and in 10 patients in the control group (33.33 %). The difference between the two groups was not statistically significant (χ = 0.88, P = 0.35). Postoperative scores for the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D) in the treatment group were significantly lower than those in the control group (P < 0.05).

CONCLUSION

The results of this study demonstrated that auricular point acupressure was effective in alleviating postoperative pain in patients with perianal abscesses and simultaneously reduced their postoperative psychological stress reactions. This dual effect provided both pain relief and a reduction of anxiety with fewer adverse reactions, making it a safe and effective treatment option.

摘要

目的

本研究旨在评估耳穴按压在缓解肛周脓肿患者术后疼痛和减轻焦虑方面的疗效。

方法

我们纳入了 2019 年 7 月至 2020 年 6 月期间在南通市第一人民医院接受一期根治性手术的 61 例肛周脓肿患者。我们将他们分为治疗组(n = 31),其中患者接受术前双侧神门、皮质下和其他穴位的耳穴按压。他们被指示每天按压五到六次,每次约 3-5 分钟。对照组(n = 30)接受常规术前准备。两组的治疗持续时间均为一周。我们比较了两组患者的疼痛视觉模拟量表(VAS)评分、术后额外使用镇痛药物的情况,以及术前和术后 6 小时、24 小时、48 小时、72 小时和 1 周,以及首次排便时的汉密尔顿焦虑和抑郁量表评分。

结果

治疗组患者在术后 48 小时、72 小时、1 周和首次排便时的 VAS 评分均低于对照组,差异具有统计学意义(均 P < 0.05)。治疗组有 7 例(22.58%)患者需要额外使用术后镇痛药物,对照组有 10 例(33.33%)患者需要使用,差异无统计学意义(χ = 0.88,P = 0.35)。治疗组术后汉密尔顿焦虑量表(HAM-A)和汉密尔顿抑郁量表(HAM-D)评分明显低于对照组(P < 0.05)。

结论

本研究结果表明,耳穴按压可有效缓解肛周脓肿患者的术后疼痛,并同时减轻其术后心理应激反应。这种双重作用不仅缓解了疼痛,还减轻了焦虑,且不良反应较少,是一种安全有效的治疗选择。

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