Clinical study on immediate pain-relieving effect of medication-separated moxibustion nursing intervention after intrauterine invasive operation

doi:10.3760/cma.j.issn.1007-1245.2023.23.040

Abstract

Abstract:

Objective　To discuss the immediate pain-relieving effect of medication-separated moxibustion nursing intervention after intrauterine invasive operation, and provide a clinical basis for the promotion of medication-separated moxibustion in pain-relieving after surgery. Methods　It was a randomized controlled trial. A total of 95 female infertility patients aged (32.40±4.32) years and scoring to severe pain after intrauterine invasive operation in Yantai Yantaishan Hospital from January 2020 to June 2022 were selected, and were randomly divided into a control group (31 cases), a heat patch group (32 cases), and a medication-separated moxibustion group (32 cases). The control group received routine pain nursing care after surgery, the heat patch group received one-time heat patch application on the lower abdomen based on pain nursing, and the medication-separated moxibustion group received acupoint application and medication-separated moxibustion care based on pain nursing. The Numeric Rating Scale (NRS) scores at each time point, pain disappearance time, pain control efficiency, and comfort level [General Comfort Questionnaire (GCQ)] of the three groups were compared, and the pain relief effect was evaluated. One-way analysis of variance, χ² test, and linear regression analysis were used. Results　(1) NRS score: the differences of average NRS score between the moxibustion group and the control group at 5 and 10 min after intervention were 1.54 points (95%CI: 0.89-2.19; P<0.001) and 2.91 points (95%CI: 2.18-3.63; P<0.001); the differences between the moxibustion group and the heat patch group were 1.41 points (95%CI: 0.76-2.05; P<0.001) and 2.00 points (95%CI: 1.28-2.72; P<0.001); the average difference between groups reached a large effect size; the NRS score of the heat patch group was lower than that of the control group, but only the difference of average NRS score at 10 min after intervention was 0.91 points (95%CI: 0.18-1.63; P<0.05). (2) Pain disappearance time: the pain disappearance time of the control group, the heat patch group, and the moxibustion group were (38.23±15.41) min, (26.09±13.48) min, and (15.50±7.99) min, respectively. The pain disappearance time of the moxibustion group was shorter than those in the other two groups, with statistically significant differences (both P<0.001). (3) Pain control efficiency: the NRS reduction degree in the moxibustion group was higher than those in the control group and the heat patch group 5 min after intervention, reaching a large effect size, with statistically significant differences (all P<0.001); there was no statistically significant difference between the heat patch group and the control group (P>0.05). The pain control efficiency in the moxibustion group was higher than those in the control group and the heat patch group, with statistically significant differences (both P<0.001). (4) Satisfaction with pain control: that in the moxibustion group was higher than those in the heat patch group and the control group (both P<0.001). (5) GCQ score: the scores of physiological, psychological, and social and cultural dimensions and the total comfort of the moxibustion group were higher than those of the control group and the heat patch group, with statistically significant differences (all P<0.001). Linear regression analysis showed that NRS score had a significant negative effect on GCQ score 10 min after intervention (r=-0.735, P<0.001). Conclusions　Doing medication-separated moxibustion to patients with severe pain after intrauterine invasive operation can effectively relieve the pain, reduce the pain discomfort time, and improve the comfort. The pain-relieving effect of medication-separated moxibustion is better is that of heat patch, which is recommended to relieve the pain after uterine operation examination.

Key words:

Medication-separated moxibustion, Intrauterine invasive operation, Immediately, Pain-relieving, Nursing intervention

摘要：

目的　探讨隔药艾灸护理干预对宫腔侵入性操作后即时止疼效果，为隔药艾灸在术后止疼方面的推广提供临床依据。方法　本研究为随机对照试验。选取2020年1月至2022年6月在烟台市烟台山医院进行宫腔侵入性操作后疼痛评分达重度疼痛的女性不孕症患者95例，年龄（32.40±4.32）岁，随机分组划分为对照组（31例）、发热贴组（32例）、隔药艾灸组（32例）。对照组术后接受常规疼痛护理，发热贴组在疼痛护理基础上给予下腹部一次性发热贴贴敷，隔药艾灸组在疼痛护理基础上给予穴位贴敷+隔药艾灸干预。对比3组各时间节点的疼痛数字评分法（NRS）评分、疼痛消失时间、疼痛控制有效率、舒适度状况［简化舒适状况量表（GCQ）］，评价止疼效果。采用单因素方差分析、χ²检验、线性回归分析。结果　⑴NRS评分：隔药艾灸组在干预后5、10 min的平均NRS评分与对照组间差异分别为1.54分（95%CI：0.89～2.19；P<0.001）、2.91分（95%CI：2.18～3.63；P<0.001）；与发热贴组间差异为1.41分（95%CI：0.76～2.05；P<0.001）、2.00分（95%CI：1.28～2.72；P<0.001）；组间平均差异达到较大效应量；发热贴组NRS评分较对照组有所降低，但只有干预后10 min平均NRS评分组间差异为0.91分（95%CI：0.18～1.63；P<0.05）。⑵疼痛消失时间：对照组、发热贴组、隔药艾灸组疼痛消失时间分别为（38.23±15.41）min、（26.09±13.48）min、（15.50±7.99）min，隔药艾灸组疼痛消失时间均短于其他两组，差异均有统计学意义（均P<0.001）。⑶疼痛控制有效率：干预后5 min，隔药艾灸组NRS降低分值均高于对照组与发热贴组，达到较大效应量，差异均有统计学意义（均P<0.001）；发热贴组与对照组间差异无统计学意义（P>0.05）；隔药艾灸组疼痛控制有效率均高于对照组和发热贴组，差异均有统计学意义（均P<0.001）。⑷疼痛控制满意度：隔药艾灸组均高于发热贴组和对照组（均P<0.001）。⑸GCQ评分：隔药艾灸组在生理、心理、社会文化维度评分及总舒适度均高于对照组和发热贴组，差异有统计学意义（均P<0.001）；线性回归分析显示，干预后10 min NRS评分会对GCQ评分产生显著的负向影响（r=-0.735，P<0.001）。结论　对宫腔侵入性操作后疼痛患者实施隔药艾灸可以有效缓解疼痛，减少疼痛不适时间，提高舒适度，且隔药艾灸的即时止疼效果优于发热贴，推荐应用于宫腔操作检查后止疼。

关键词:

隔药艾灸, 宫腔侵入性操作, 即时, 止疼, 护理干预

Zhang Aiyu.

Clinical study on immediate pain-relieving effect of medication-separated moxibustion nursing intervention after intrauterine invasive operation [J]. International Medicine and Health Guidance News, 2023, 29(23): 3501-3506.

张爱玉.

隔药艾灸护理干预对宫腔侵入性操作后患者即时止疼效果的临床研究 [J]. 国际医药卫生导报, 2023, 29(23): 3501-3506.

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