腕踝针联合吴茱萸热熨疗法改善PCNL术后疼痛的效果观察

doi:10.3760/cma.j.issn.1007-1245.2022.23.015

国际医药卫生导报 ›› 2022, Vol. 28 ›› Issue (23): 3316-.DOI: 10.3760/cma.j.issn.1007-1245.2022.23.015

腕踝针联合吴茱萸热熨疗法改善PCNL术后疼痛的效果观察

陈敏^1,2 陈金兰^1,2 朱锐^1,2 梁斯扬^1,2 苏郑明^1,2 卞军^1,2 周楚善³ 冯梓华³

¹广州医科大学附属第五医院泌尿外科，广州　510700；²广东高校生物靶向诊治与康复重点实验室，广州　510700；³广州医科大学第五临床学院，广州　510700

收稿日期:2022-08-09 出版日期:2022-12-01 发布日期:2022-12-17
通讯作者: 陈金兰，Email：lailan@163.com
基金资助:
广东省中医药局科研项目（20211250）；广东高校生物靶向诊治与康复重点实验室（2021KSYS009）；广东省医学科研项目（A2021351）；广州市医学重点学科项目（2021-2023）；广州医科大学临床重点专科（广医大发〔2020〕5号）

Wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing in treating pain after PCNL

Chen Min^1,2, Chen Jinlan^1,2, Zhu Rui^1,2, Liang Siyang^1,2, Su Zhengming^1,2, Bian Jun^1,2, Zhou Chushan³, Feng Zihua³

¹Department of Urological Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, China; ²Key Laboratory of Biological Targeting Diagnosis, Therapy, and Rehabilitation, Guangdong Higher Education Institutes, Guangdong 510700, China; ³The Fifth Clinical College of Guangzhou Medical University, Guangzhou 510700, China

Received:2022-08-09 Online:2022-12-01 Published:2022-12-17
Contact: 陈金兰，Email：lailan@163.com
Supported by:
Scientific Research Project of Guangdong Bureau of Traditional Chinese Medicine (20211250); Key Laboratory of Guangdong Higher Education Institutes (2021KSYS009); Medical Scientific Research Project of Guangdong Province (A2021351); Guangzhou Medical Key Discipline Project (2021-2023); Key Clinical Specialty Project of Guangzhou Medical University (No.20205)

摘要/Abstract

摘要：

目的　探讨腕踝针联合吴茱萸热熨疗法在改善经皮肾镜碎石取石术（percutaneous nephrolithotomy，PCNL）术后患者疼痛中的临床疗效。方法　本研究采用随机对照试验，选取2021年1月1日至2022年5月30日在广州医科大学附属第五医院泌尿外科行PCNL治疗的120例患者，随机数字表法分为4组，每组30例。双氯芬酸钠组男17例、女13例，年龄（51.68±5.88）岁；腕踝针组男20例、女10例，年龄（49.91±6.71）岁；吴茱萸组男18例、女12例，年龄（50.28±8.33）岁；腕踝针联合吴茱萸组男17例、女13例，年龄（49.07±8.91）岁。比较4组治疗前后疼痛数字评定量表（NRS）评分、镇痛起效时间、镇痛保持时间以及不良反应。计量资料采用方差分析事后检验，计数资料采用χ²检验。结果　4组患者的初始疼痛评分比较，差异无统计学意义（P=0.305）。腕踝针联合吴茱萸组在干预5 min后即可见显著疗效，15 min后初始疼痛评分平均分由3.10分下降至1.12分，持续至120 min时NRS评分为0.68分，该组患者疼痛评分下降幅度最大；腕踝针组单独镇痛时下降曲线缓慢；吴茱萸组在干预60 min后疼痛评分结果回升；双氯芬酸钠组在干预15 min内未见明显缓解，出现恶心呕吐1例，后可自行缓解，其余3组均未出现相应并发症。结论　腕踝针联合吴茱萸热熨能有效改善PCNL术后疼痛，安全性好，起效迅速且作用持久。

关键词: 腕踝针, 吴茱萸热熨, 经皮肾镜碎石取石术, 疼痛, 效果观察

Abstract: Objective　To investigate the clinical effect of wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing in reducing pain score in patients after percutaneous nephrolithotomy (PCNL). Methods　One hundred and twenty patients who underwent PCNL in Department of Urological Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University from January 2021 to May 2022 were included in this randomized controlled trial. They were randomly divided into four groups, with 30 cases in each group. There were 17 males and 13 females in the diclofenac sodium group who were (51.68±5.88) years old, 20 males and 10 females in the wrist-ankle acupuncture group who were (49.91±6.71) years old, 18 males and 12 females in Evodia group who were (50.28±8.33) years old, and 17 males and 13 females in the wrist-ankle acupuncture combined with Evodia japonica group who were (49.07±8.91) years old. The pain scores calculated by Numerical Rating Scale (NRS), analgesic onset times, analgesic retention times, and adverse reactions were compared between the four groups before and after the treatment. The measurement data were analyzed by ANOV, and the enumeration data chi-square test. Results　There was no statistical difference in pain score between the four groups (P=0.305). The wrist-ankle acupuncture combined with Evodia rubra group showed significant effect 5 minutes after the intervention, and the average pain score was 1.12 after 15 minutes. The pain score was 0.68 after 120 minutes, and was more superior than the other groups. The wrist-ankle acupuncture group showed a slow decline during the observative point. After 60 minutes' intervention, the pain score in the Evodia rubra group increased. The diclofenac sodium group did not see significant pain relief in the initial 15 minutes. One case of nausea and vomiting occurred in the diclofenac sodium group. Complications did not occurred in the other three groups. Conclusion　Wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing is a safe option in improving pain after PCNL with rapid and long-lasting effect.

Key words: wrist-ankle acupuncture, Evodia rutaecarpa hot ironing, PCNL, Pain, Effect observation

陈敏陈金兰朱锐梁斯扬苏郑明卞军周楚善冯梓华. 腕踝针联合吴茱萸热熨疗法改善PCNL术后疼痛的效果观察[J]. 国际医药卫生导报, 2022, 28(23): 3316-.

Chen Min, Chen Jinlan, Zhu Rui, Liang Siyang, Su Zhengming, Bian Jun, Zhou Chushan, Feng Zihua. Wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing in treating pain after PCNL[J]. International Medicine and Health Guidance News, 2022, 28(23): 3316-.

参考文献

[1] 高小峰,李凌.输尿管软镜在肾结石治疗中的应用[J].现代泌尿外科杂志,2011,16(5):387-390,398.DOI:10.3969/j.issn.1009-8291.2011.05.001.
[2] 曾国华,李逊,吴开俊,等.微创经皮肾镜取石术治疗孤立肾肾结石[J].中国内镜杂志,2003,9(9):4-5.DOI:10.3969/j.issn.1007-1989.2003.09.002.
[3] Xu LP, Yang SL, Su SQ, et al. Effect of wrist-ankle acupuncture therapy combined with auricular acupuncture on cancer pain: a four-parallel arm randomized controlled trial[J]. Complement Ther Clin Pract, 2020,39:101170. DOI: 10.1016/j.ctcp.2020.101170.
[4] 卞少华,李颖毅,张辉,等.可视化穿刺系统在经皮肾镜碎石术治疗无积水肾结石中的安全性和有效性[J].临床医学研究与实践,2021,6(31):60-62.DOI:10.19347/j.cnki.2096-1413.202131018.
[5] 荣珍珠.集束化护理对36例PCNL术后患者疼痛程度及生活质量的影响[J].中外医学研究,2018,16(18):102-104.DOI:10.14033/j.cnki.cfmr.2018.18.046.
[6] 包琼.护理干预对经皮肾镜术后患者疼痛的影响[J].中国妇幼健康研究,2017,28(S3):629-630.
[7] 曾建峰,赖海标,钟喨,等.腕踝针治疗输尿管下段结石内镜术后腰痛的临床疗效[J].中国全科医学,2016,19(S1):142-143.
[8] 张心曙,凌昌全,周庆辉.实用腕踝针疗法[M].北京:人民卫生出版社,2002.
[9] 凌昌全,周庆辉,顾伟.腕踝针[M].上海:科学技术出版社,2019.
[10] 江淑红,刘岩,庄萍萍,等.腕踝针联合穴位注射对急性腰扭伤患者炎症因子、α-颗粒膜糖蛋白及MMP-3表达的影响[J].中国中医急症,2022,31(5):857-860.DOI:10.3969/j.issn.1004-745X.2022.05.028.
[11] 许煜婷,南睿星,李惠标,等.腕踝针治疗原发性痛经疗效的Meta分析[J].中医临床研究,2022,14(19):137-141.DOI:10.3969/j.issn.1674-7860.2022.19.042.
[12] 杨剑辉,杨敏怡,冯桂贞,等.吴茱萸热奄包热熨法联合耳穴压豆对肾绞痛患者的影响[J].国际护理学杂志,2020,39(5):839-841.DOI:10.3760/cma.j.issn.1673-4351.2020.05.024.
[13] 周洋,董联玲.中医热熨法的研究进展[J].实用医技杂志,2016,23(9):976-978.
[14] 万丽,赵晴,陈军,等.疼痛评估量表应用的中国专家共识(2020版)[J].中华疼痛学杂志,2020,16(3):177-187.DOI:10.3760/cma.j.cn101379-20190915-00075.
[15] 韩茜,刘玉平,陈婕.疼痛评估量表应用于慢性非癌痛患者对疼痛评分及情绪的影响[J].现代中西医结合杂志,2019,28(21):2371-2374.DOI:10.3969/j.issn.1008-8849. 2019.21.024.
[16] 赵振华,徐勋,冯权尧,等.经皮肾镜取石术术后疼痛危险因素分析及临床处理[J].临床泌尿外科杂志,2021,36(5):366-370.DOI:10.13201/j.issn.1001-1420.2021.05.007.
[17] 伍信阳,张巧珍,李艳芳,等.无管化微创经皮肾镜取石术后留置输尿管外支架对术后疼痛和感染的预防效果[J].广东医学,2019,40(1):101-104.DOI:10.13820/j.cnki.gdyx.20183317.
[18] 刘宁,柏金明,何汀,等.微通道PCNL与无管化微通道PCNL治疗肾结石的疗效及对术后疼痛、睡眠质量的影响[J].世界睡眠医学杂志,2021,8(11):1886-1888.DOI:10.3969/j.issn.2095-7130.2021.11.008.
[19] Shah HN, Shah RH, Sodha HS, et al. A randomized control trial evaluating efficacy of nephrostomy tract infiltration with bupivacaine after tubeless percutaneous nephrolithotomy[J]. J Endourol, 2012,26(5):478-483. DOI: 10.1089/end.2011.0465.
[20] Eismann L, Stief CG, Chaloupka M. Akute Nierenkolik [Treatment of acute renal colic][J]. MMW Fortschr Med, 2021,163(3):56-57. DOI: 10.1007/s15006-021-9558-7.
[21] Leveridge M, D'Arcy FT, O'Kane D, et al. Renal colic: current protocols for emergency presentations[J]. Eur J Emerg Med, 2016,23(1):2-7. DOI: 10.1097/MEJ.0000000000000324.
[22] Silva S, Almeida M, Rodrigues L, et al. Acute renal colic: beyond kidney stones[J]. Nefrologia, 2016,36(2):182-184. DOI: 10.1016/j.nefro.2015.09.001.
[23] 楚鑫,蒋运兰,曾洋洋,等.基于"腕踝针"的中西医结合疼痛管理在骨转移癌患者中的应用研究[J].成都中医药大学学报,2018,41(3):41-45.DOI:10.13593/j.cnki.51-1501/r.2018.03.041.
[24] 张春鹏,周庆辉.腕踝针镇痛机制探讨[J].辽宁中医药大学学报,2018,20(2):74-76.DOI:10.13194/j.issn.1673- 842x. 2018.02.021.
[25] 胡美珠.吴茱萸中药热奄护理用于肾结石患者的止痛效果探析[J].系统医学,2020,5(19):182-184.DOI:10.19368/j.cnki.2096-1782.2020.19.182.
[26] 刘玉简,黄健,林丝敏.腕踝针在急性肾绞痛中的应用效果[J].中国医药科学,2021,11(3):4-7.
[27] 章徐洁,吴金玉,姚梅琪.腕踝针镇痛在疼痛护理中的临床应用进展[J].新中医,2020,52(23):126-129.DOI:10.13457/j.cnki.jncm.2020.23.036.
[28] 谢文锋,黄莉梅,潘国全,等.14F微创单通道经皮肾镜取石术在上尿路<3 cm结石中的应用[J].国际医药卫生导报,2020,26(9):1217-1219.DOI:10.3760/cma.j.issn.1007-1245. 2020.09.009.
[29] 岳闯,左立,鹿超,等.超细经皮肾镜取石术治疗1～2 cm肾结石患者的体会[J].国际医药卫生导报,2020,26(9):1214-1217.DOI:10.3760/cma.j.issn.1007-1245.2020. 09.008.
[30] 姜刚刚,曾鹏,蓝子权,等.肾鹿角形结石截石斜仰卧位及俯卧位下经皮肾镜碎石取石术的研究[J].国际医药卫生导报,2022,28(12):1684-1688.DOI:10.3760/cma.j.issn. 1007-1245.2022.12.013.
[31] 王琪,夏厚纲,王丹丹,等.腕踝针用于腰椎手术患者术后镇痛效果的临床观察[J].辽宁医学杂志,2022,36(3):60-62.

腕踝针联合吴茱萸热熨疗法改善PCNL术后疼痛的效果观察

Wrist-ankle acupuncture combined with Evodia rutaecarpa hot ironing in treating pain after PCNL

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