电针对全膝关节置换术后辅助镇痛的临床疗效观察

作     者：石威 侯燕 严伟 谭勇海 余昕 李磊 邹德宝 王杰 王志洲 姜红江 Wei SHI;Yan HOU;Wei YAN;Yong-hai TAN;Xin YU;Lei LI;De-bao ZOU;Jie WANG;Zhi-zhou WANG;Hong-jiang JIANG

作者机构：安徽中医药大学研究生院合肥230000 山东省文登整骨医院关节三科威海264400 

出 版 物：《World Journal of Acupuncture-Moxibustion》 (世界针灸杂志（英文版）)

年 卷 期：2022年第32卷第2期

页      面：131-136页

核心收录：

学科分类：1005[医学-中医学] 1002[医学-临床医学] 100512[医学-针灸推拿学] 10[医学] 

基　　金：Supported by the Fourth Batch Key TCM Specialty Construction Projects in Weihai City(Orthopedics)(Weihai Health Administration OfficeNo.87)。 

主　　题：Total knee arthroplasty Postoperative pain Electroacupuncture Analgesia Effect mechanism 

摘      要：Objective:To observe the clinical effect of electroacupuncture(EA)for alleviating pain after total knee arthroplasty(TKA)in the patients with the end-stage knee osteoarthritis and its mechanism.Methods:A total of 80 subjects with unilateral TKA were divided into a celecox group(40 cases)and an EA combination group,using random number table in clinical trial.In the celecox group,after operation,celecox tablets were taken orally for analgesia.In the EA combination group,on the base of oral administration of celecox tablets,on the day of operation,EA was exerted on the affected limb,with disperse-dense wave,2 Hz/100 Hz in frequency,3 mA in current intensity,once daily,30 min each time,consecutively for 3 days.On the day after operation,Wàiqiū(外丘GB36),Jīnmén(金门BL63),Nèimádiǎn(内麻点EX-LE29)and ZúsānIǐ(足三里ST36)were selected in EA.24 h after removing the drainage tube,Liángqiū(梁丘ST34),Xuèhǎi(血海SP10),Dìjī(地机SP8)and Yánglíngquán(阳陵泉GB34)were used.Separately,the operation time,blood loss,the pain VAS score before operation,the pain VAS scores after 24,48 and 72 h of treatment and Self-rating scale of sleep(SRSS)score,as well as the stress factors,i.e.IL-6,IL-10 and TNF-αin serum were recorded and determined in the subjects of two groups.Results:Before treatment,the operation time and blood loss were not different between two groups(both P0.05).24,48 and 72 h after operation,the visual analogue scale(VAS)scores in the celecox group were all higher than those in the EA combination group(all P0.05).After treatment,SRSS score in the EA combination group was lower than that in the celecox group(P0.05).The expressions of IL-6 and TNF-αwere reduced gradually in the two groups(all P0.05)and the values in the EA combination group were lower than the celecox group(P0.05).IL-10 was increased gradually(P0.05)and the value in the EA combination group was higher than the celecox group(P0.05).Conclusion:Electroacupuncture effectively alleviates pain induced by TKA and the curative effect is definite.This therapy contributes to accelerating rehabilitation and its effect mechanism may be related to promoting the release of anti-inflammatory factor,IL-10 and inhibiting the expressions of inflammatory factors,IL-6 and TNF-α.