活血通络针刺法治疗混合痔外剥内扎术后疼痛的临床研究

发布时间：2018-07-03 20:42

本文选题：混合痔 + 外剥内扎术　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:观察并评价活血通络针刺法治疗混合痔外剥内扎术后疼痛的临床疗效,探讨活血通络针刺法在缓解混合痔外剥内扎术后疼痛症状的机制和临床应用价值,为临床治疗混合痔外剥内扎术后疼痛提供安全有效的治疗方法。方法:将符合标准的60例患者随机分为治疗组、对照组各30例。治疗组采用活血通络针刺法治疗,对照组采用口服盐酸曲马多片治疗。观察并记录患者2h、4h、10h、24h、48h、72h疼痛VAS、VRS评分,镇痛起效时间,术后发生不良反应情况,镇痛药物使用情况比较,统计数据采用SPSS22.O统计软件进行分析。结果:1、主要疗效评价指标:(1)术后VAS评分比较,两组患者术后2h、4h、10h、24h、72h比较无显著差异(P0.05),无统计学意义,治疗组与对照组疗效相当,因此可以认为治疗组和对照组对混合痔术后疼痛均有止痛作用;术后第48h小时的疼痛VAS积分比较差异具有显著性(P0.05),具有统计学意义,治疗组止痛疗效优于对照组;(2)两组患者术后2h、4h、10h、24h、48h、72h VRS评分比较无显著差异(P0.05),无统计学意义,治疗组与对照组疗效相当;(3)经重复测量方差分析,(1)两组之间相同时间VAS评分比较,差异有统计学意义(F=7.25,P=0.0093);两组组内不同治疗时间之间VAS评分比较,差异有统计学意义(F=31.09,P=0.0000);治疗时间与VAS评分之间无交互效应(F=0.08,P=0.493);(2)两组之间相同时间VRS评分比较,差异无统计学意义(F分组=3.53,P分组=0.656);两组组内不同治疗时间之间VRS评分比较,差异有统计学意义(F时间=3.12,P时间=0.0092);治疗时间与VRS评分之间无交互效应(F交互=0.52,P交互=0.762)。2、次要疗效评价指标:(1)术后两组镇痛起效时间比较差异具有显著性(P0.05),有统计学意义,治疗组优于对照组,说明活血通络针刺法镇痛效果快于对照组;(2)两组术后发生不良反应人数比较差异十分显著(P0.01),具有统计学意义,治疗组不良反应人数较对照组少,可以认为治疗组具有更高的安全性;(3)镇痛药物使用情况比较差异有统计学意义(P0.01),治疗组镇痛药物人均用量远低于对照组。结论:活血通络针刺法在治疗混合痔外剥内扎术后疼痛具有确切的疗效,能减轻疼痛强度,缓解疼痛症状,镇痛迅速,减少术后不良情况的发生,安全有效,为临床提供了一项新的治疗手段。
[Abstract]:Objective: to observe and evaluate the clinical effect of activating blood circulation and Tongluo acupuncture on the pain after external exfoliation and internal ligation of mixed hemorrhoids, and to explore the mechanism and clinical application value of activating blood circulation Tongluo acupuncture in relieving the pain symptoms after external stripping and internal ligation of mixed hemorrhoids. To provide a safe and effective method for the treatment of pain after external exfoliation and internal ligation of mixed hemorrhoids. Methods: 60 patients were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated by activating blood circulation and collaterals acupuncture, and the control group was treated with tramadol hydrochloride tablets. The VRS scores, the onset time of analgesia, the adverse reactions after operation and the use of analgesic drugs were observed and recorded. The statistical data were analyzed by SPSS 22.O. Results: (1) there was no significant difference in VAS score between the two groups (P0.05), and there was no significant difference between the two groups (P0.05), and the curative effect of the treatment group was similar to that of the control group. It can be concluded that the treatment group and the control group have analgesic effect on postoperative pain of mixed hemorrhoids, and the VAS scores of pain at 48h after operation have significant difference (P0.05), which has statistical significance. The curative effect of the treatment group was better than that of the control group, (2) there was no significant difference in VRS score between the two groups (P0.05), there was no significant difference in VRS score between the two groups (P0.05), there was no significant difference between the treatment group and the control group; (3) after repeated measurement of variance analysis, (1) VAS scores were compared at the same time between the two groups. There were significant differences in VAS scores between the two groups (F0. 25 P0. 0093), there were significant differences in the VAS scores between the two groups at different treatment times (F0. 09% P0. 0000), and there was no interaction between the treatment time and the VAS score (F0. 08% PX 0. 493); (2) between the two groups at the same time. There was no significant difference between the two groups (F group, 3.53 P group, 0.656), and the VRS scores were compared between the two groups at different treatment time. The difference was statistically significant (F time was 3.12p time 0.0092), there was no interactive effect between treatment time and VRS score (F interaction time: 0.52P interaction: 0.762). Secondary efficacy evaluation index: (1) there was significant difference in analgesia onset time between the two groups (P0.05), there was significant difference between the two groups (P0.05), and there was significant difference between the two groups (P0.05), and there was no significant difference between the treatment time and the VRS score (P < 0.05). The treatment group was superior to the control group, indicating that the analgesic effect of the acupuncture method of activating blood circulation and dredging collaterals was faster than that of the control group; (2) the number of adverse reactions in the treatment group was significantly different (P0.01), and the number of adverse reactions in the treatment group was less than that in the control group. It can be considered that the treatment group has higher safety; (3) the use of analgesic drugs was significantly different (P0.01), the average dosage of analgesic drugs in the treatment group was much lower than that in the control group. Conclusion: the acupuncture method of activating blood circulation and dredging collaterals is effective in the treatment of pain after external exfoliation and internal ligation of mixed hemorrhoids, which can reduce the intensity of pain, relieve the symptoms of pain, relieve pain quickly, reduce the occurrence of adverse conditions after operation, and be safe and effective. It provides a new treatment for clinic.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R266

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