| 毛原夫,王文波,姜泽宇,等.电针对膝关节置换术后病人的镇痛作用及血清前列腺素 E2及 β-内啡肽的影响[J].安徽医药,2021,25(10):1977-1981. |
| 电针对膝关节置换术后病人的镇痛作用及血清前列腺素 E2及 β-内啡肽的影响 |
| The analgesic effect of electroacupuncture in patients after knee replacement and its influence on serum prostaglandin E2 and β-endorphin |
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| DOI：10.3969/j.issn.1009-6469.2021.10.016 |
| 中文关键词: 电针 镇痛 前列腺素 E2 β-内啡肽 关节成形术，置换，膝 疼痛，手术后 |
| 英文关键词: Electroacupuncture Analgesia Prostaglandin E2 ative |
| 基金项目:黑龙江省卫生厅科研课题( 2012230) |
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| 中文摘要: |
| 目的探讨电针用于膝关节置换术后病人的镇痛作用及对血清前列腺素 E2)及 β-内啡肽的影响。方法(PGE2选取哈尔滨医科大学附属第一医院 2017年 3月至 2019年 3月哈尔滨医科大学附属第一医院收治的 90例行全膝关节置换术病人，采用随机数字表法分为对照组与电针组，每组 45例。对照组于术后采取药物镇痛，电针组在术前 3d至术后 5d采用电针进行镇痛。比较两组病人术后不同时相点的活动痛视觉模拟评分法( VAS)评分与静息痛 VAS评分、膝关节主动活动度与被动活动度、术前 3d与术后第 7天的血清 PGE2β-内啡肽、不良反应发生率。结果两组术后 12 h的静息痛 VAS评分与活动痛 VAS评分、膝关节主动活动度与被动活动度的差、异无统计学意义( P>0.05)。电针组术后 24 h、48 h、120 h的静息痛 VAS评分［( 5.44±1.08)分比( 6.12±1.04)分，(4.26±1.02)分比( 5.57±1.15)分，(2.21±0.43)分比( 3.37±0.32)分］与活动痛 VAS评分［( 5.44±1.08)分比( 6.41±1.02)分，(4.59±1.07)分比( 5.82±1.16)分，(2.43±0.51)分比( 3.42±0.41)分］均低于对照组，膝关节主动活动度与被动活动度均高于对照组( P<0.05)。术前 3d，两组病人血清 PGE2与 β-内啡肽水平水平相近( P>0.05)；术后第 7天，两组 PGE2水平均明显下降， β-内啡肽明显升高( P<0.05)。术后第 7天，［( 173.23±11.92)pg/mL比( 207.11±12.17)pg/mL］低于对照电针组 PGE2组， β-内啡肽［( 289.23±11.52)pg/mL比( 237.11±12.40)pg/mL］高于对照组( P<0.05)。电针组术后不良反应发生率低于对照组(4.44%比 20.00%，P<0.05)。结论电针可有效下调血清 PGE2并上调 β-内啡肽发挥更理想的术后镇痛效果，促进病人术后膝关节活动度的更快恢复，且安全性更高。 |
| 英文摘要: |
| Objective To investigate the analgesic effect of electroacupuncture on knee replacement and its effect on serum prostaglandinE2(PGE2)and β-endorphin.Methods Ninety patients undergoing total knee arthroplasty admitted to The First Affiliated Hospital of Harbin Medical University from March 2017 to March 2019 were selected and assigned into control group and electroacupuncture group by random number table method, with 45 cases in each group. The control group received medication for analgesia after theoperation, and the electroacupuncture group received electroacupuncture for analgesia from 3 days before the operation to 5 days afterthe operation. The active pain visual analogue score (VAS) and resting pain VAS score, active and passive knee ranges of motion at different time points after the operation, serum PGE2 and β-endorphin levels 3 days before operation and 7 days after operation, incidenceof adverse reactions were compared between the two groups.Results There were no significant differences in active pain and restingpain VAS scores, active and passive knee ranges of motion between the two groups at 12 h after operation (P>0.05). The resting pain VAS scores of 24 h, 48 h, 120 h after operation in the electroacupuncture group [(5.44±1.08) points vs (6.12±1.04) points, (4.26±1.02) points vs (5.57±1.15) points, (2.21±0.43) points vs (3.37±0.32) points] and active pain VAS scores [(5.44±1.08) points vs (6.41±1.02) points, (4.59±1.07) points vs (5.82±1.16) points, (2.43±0.51) points vs (3.42±0.41) points] were lower than those in the control group,and the active and passive knee ranges of motion in the electroacupuncture group were higher than those in the control group (P<0.05). The serum PGE2 and β-endorphin levels of the two groups of patients were similar at 3 days before the operation (P>0.05). On the 7th day after operation, the PGE2 levels were significantly decreased, and β-endorphin were significantly increased in both groups (P< 0.05). On the 7th day after operation, the PGE2 [(173.23±11.92) pg/mL vs (207.11±12.17) pg/mL] was lower, and β-endorphin [(289.23±11.52) pg/mL vs (237.11±12.40) pg/mL] was higher in the electroacupuncture group than in the control group (P<0.05). The incidence of adverse reactions in the electroacupuncture group was lower than that in the control group (4.44% vs 20.00%, P<0.05).Conclusion Electroacupuncture can effectively improve the postoperativeanalgesia effectby effectively lowering serum PGE2 and up-regulating βendorphin, promote the faster postoperative recovery of knee range of motion, and achieve higher safety. |
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