世界中医药

目的：观察电针合谷和内关穴对颈椎前路手术后急性疼痛的有效性和安全性。方法：选择因颈椎骨折入院，择期经颈前路行骨折切开复位内固定术的患者60例，随机分为电针组（30例）和药物组（30例）。电针组使用电针刺激合谷和内关穴，分别于术前30 min，手术结束缝皮时继续电针治疗。麻醉方式及用药两组相同。结果：1）平均动脉压、心率变化：电针组术前、拔管前、拔管后平均动脉压、心率与术中比较P<0.01，拔管后与拔管前比较P>0.05。药物组拔管后与拔管前比较平均动脉压P<0.01，心率P<0.05。2）意识恢复，拔管时间：电针组明显短于药物组，组间比较差异有统计学意义P<0.01。3）对两组患者拔管即刻，拔管后2 h，4 h，8 h，12 h，24 h进行VAS和Ramsay评分显示，电针组在拔管后4 h内镇痛镇静优于药物组，差异有统计学意义P<0.05，拔管后2 h内镇痛差异有统计学意义P<0.01。药物组6例发生恶心、呕吐、便秘等不良反应，电针组1例。术后24 h PCA按压次数药物组共计116次，电针组21次，两组比较差异有统计学意义P<0.05。结论：电针刺激合谷和内关穴可有效减轻颈椎手术后急性疼痛，患者血流动力学平稳，意识恢复和拔管时间短，苏醒快，镇痛效果显著，不良反应降低，提高了手术安全性。

English Summary:

To observe the effectiveness and safety of electro acupuncture on Hegu point and Neiguan point to treat acute pain after surgery on anterior cervical spine.Methods：Sixty patients with cervical spine fracture who were about to be given relocation and internal fixation were randomly divided into electro acupuncture group (n=30) and drug group (n=30). Patients in electro acupuncture group were given electro acupuncture on Neigu point and Neiguan point 30 mins before the surgery and after surgery being sutured. The anesthesia method and applied drugs were the same in both groups. Results：1)As for electro acupuncture group, the average changes of arterial blood pressure and heart rate before surgery, before extubation, and after extubation were significantly different from those during the surgery (P<0.01), while the changes had no significant differences between the levels before extubation and after extubation (P>0.05); 2)Electro acupuncture had significantly shorter consciousness recovery and exubation time than the drug team(P<0.01); 3) Patients in both groups were given VAS and Ramsay evaluation 2 hours, 4 hours, 8 hours, 12 hours, 24 hours after extubation. Electro acupuncture group showed better analgesia effect within 4 hours after extubation compared with drug group (P<0.05); 4) There were 6 side effects occurred in drug group including nausea, vomiting, and constipation, and there was 1 happened in the electro acupuncture group. 5) The pressure times of PCA 24 hours after surgery were 116 times in drug group and 21 times in the electro acupuncture group, and the differences were significant (P<0.05).Conclusion：Electro acupuncture on Hegu point and Neiguan point can effectively ease the acute pain after surgery cervical spine with stable hemodynamics , short consciousness recovery and extubation time, significant analgesia effect and low side effects occurrence rate.

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