Abstract
Objective
To explore the clinical efficacy of ear acupuncture plus injection at Zusanli (ST 36) in treating shoulder pain after laparoscopic gynecological surgery, and to observe its effect on cytokines.
Methods
Two hundred patients with shoulder pain after laparoscopic gynecological surgery were randomized into two groups based on their visiting sequence, 100 cases each. The observation group was intervened by ear acupuncture plus injection at Zusanli (ST 36), and the control group was intervened by oral administration of Ibuprofen, 10 d as a treatment course. The clinical efficacies of the two groups were compared after 2 treatment courses; the visual analogue scale (VAS), present pain intensity (PPI) and 36-item short-form health survey (SF-36) were measured before and after the treatment; the changes of interleukin (IL)-6 and IL-10 after the treatment were also observed.
Results
The VAS and PPI scores were significantly changed after the treatment in both groups (both P<0.01). After the treatment, the VAS score in the observation group was significantly different from that in the control group (P<0.05). The component scores of SF-36 were significantly changed after the treatment in both groups (P<0.01); after the treatment, the scores of physical functioning (PF), bodily pain (BP), social functioning (SF), and mental health (MH) in the observation group were significantly different from those in the control group (all P<0.05). The contents of IL-6 and IL-10 dropped significantly after the intervention in both groups (both P<0.01), and the between-group differences were also statistically significant (both P<0.01). The total effective rate of the observation group was higher than that of the control group (P<0.05).
Conclusion
Ear acupuncture plus injection at Zusanli (ST 36) can significantly improve the shoulder pain after laparoscopic gynecological surgery, down-regulate the expressions of IL-6 and IL-10, and boost the recovery.
摘要
目的
探讨耳针配合足三里穴位注射治疗妇科腹腔镜术后肩痛的临床疗效, 并观察其对细胞因子的影响。
方法
将200例妇科腹腔镜术后肩痛的患者按就诊先后顺序随机分为2组, 每组100例。观察组采用耳针配合足三 里穴位注射治疗, 对照组口服布洛芬治疗。治疗10 d 为一个疗程, 治疗2个疗程后比较两组临床疗效及视觉模拟 量表(VAS)、现有疼痛强度(PPI)及生活质量量表(SF-36)评分的变化情况, 同时观察两组患者白细胞介素-6(IL-6)和 IL-10的变化情况。
结果
两组治疗前后的VAS 及PPI 评分均有统计学差异(均P<0.01)。治疗后, 观察组VAS 评分 与对照组有统计学差异(P<0.05)。治疗前后两组SF-36各项评分比较均有统计学差异(P<0.01); 治疗后, 观察组躯 体活动功能(PF), 躯体疼痛(BP), 社会交往能力(SF)和心理健康(MH)评分与对照组差异有统计学意义(均P<0.05)。 治疗后两组IL-6和IL-10含量均明显下降, 与本组治疗前比较均有统计学差异(均P<0.01), 两组间差异亦有统计学 意义(均P<0.01)。观察组总有效率高于对照组(P<0.05)。
结论
耳针配合足三里穴位注射治疗能显著改善妇科 腹腔镜术后患者肩痛的情况, 减少细胞因子IL-6、IL-10的表达, 促进病情的恢复。
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References
Xu LX. Observation of the characteristics of pain after laparoscopy and the nursing care. Yixue Linchuang Yanjiu, 2006, 23(9): 1517–1518.
Pan XJ, Wang YP, Wang XL. The efficacy of knee-chest position and oxygen therapy in the management of shoulder pain after gynecological laparoscopy. Zhonghua Huli Zazhi, 2010, 45(3): 240–241.
Di Massa A, Avella R, Gentili C. Respiratory dysfunction related to diaphragmatic shoulder pain after abdominal and pelvic laparoscpy. Minerva Anestesiol, 1996, 62(5): 171–176.
Zhang H, Wu XM. Incidence and influential factors of post-perative nausea and vomiting following gynecological surgery: analysis of 492 cases. Zhonghua Yixue Zazhi, 2009, 89(11): 758–762.
Liu Y, Sun YM, Zheng H. Risk factors for nausea and vomiting following gynecological laparoscopic surgery in adults. Xinjiang Yike Daxue Xuebao, 2008, 31(9): 1202–1204.
Sun ZY, Leng JH, Lang JH, Liu ZF. Prospective factors of postoperative pain following gynecologic laparoscopic surgery. Shiyong Fuchanke Zazhi, 2004, 20 (5): 299–301.
Feng XM, Zeng CM, Li JL. Analysis of the relevant factors of neck-shoulder pain after laparoscopy and the nursing care. Zhonghua Huli Zazhi, 2007, 42(1): 83–84.
State Administration of Traditional Chinese Medicine. Criteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine. Nanjing: Nanjing University Press, 1994: 186-187.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care, 1992, 30(6): 473–483.
Ma CX, Ni SD, Fu XH. Clinical observation of acupoint injection plus intravenous analgesia for pain after caesarean delivery. Zhongguo Zhongyi Jizheng, 2015, 24(1): 165–166.
Alexander JI. Pain after laparoscopy. Br J Anaesth, 1997, 79(3): 369–378.
Mouton WG, Bessell JR, Otten KT, Maddern GJ. Pain after laparoscopy. Surg Endosc, 1999, 13(5): 445–448.
Zhou J, Liang CZ, Jiang CQ, Ye YP, Zhang XS, Hao ZY, Su PY, Cheng ZS. The changes of renin-angiotensinaldosterone system in CO2 pneumoperitoneum during retroperitoneal laparoscopic surgery. Fuqiangjing Waike Zazhi, 2010, 15(2): 92–94.
Huang SG, Li GY, Zhuang GL. Research progress of laparoscopy on body stress reactions. Xiandai Fuchanke Jinzhan, 2004, 13(2): 131–133.
Zhou WD, Wei X, Xie ZQ, Zhu YL, Pan JH. Effects of retroperitoneal and transperitoneal endoscopic surgery on carbon dioxide absorption during pneumoperitoneum. Linchuang Mazuixue Zazhi, 2010, 26(9): 756–758.
Han WY, Jia DL, Li SQ, Li M, Wang J, Guo XY. Effects of retroperitoneal carbon dioxide pneumoperitoneum on the correlation of PaCO2-PetCO2 and cardiovascular systems in aged patients. Shangdong Yiyao, 2011, 51(4): 18–20.
Diao LH, Yang ZB, Zhou GX, Chen Y, Fan LY, Zhang YY, Liu H, Liu ST. Observation on therapeutic effects of electroacupuncture at Neiguan (PC 6) on silent myocardial ischemia. Zhongguo Zhen Jiu, 2011, 31(7): 591–594.
Liu WR. Therapeutic observation of acupuncture in treating functional dyspepsia and its effects on serum ghrelin. Shanghai Zhenjiu Zazhi, 2015, 34(10): 914–916.
Wu JM, Wang BJ, Zhuo YY. Therapeutic observation of auricular acupuncture plus acupoint injection at Zusanli (ST 36) for shoulder pain due to gynecologic laparoscopy. Shanghai Zhenjiu Zazhi, 2016, 35(7): 863–865.
Acknowledgments
This work was supported by Project of Science and Technology Innovation Committee of Shenzhen Municipality (深圳市科技创新委员会资助项目, No. JCY201404143700889).
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Wang, Bj., Wu, Jm., Liu, Yc. et al. Effect of ear acupuncture plus injection at Zusanli (ST 36) on shoulder pain and cytokines after gynecologic laparoscopic surgery. J. Acupunct. Tuina. Sci. 15, 290–295 (2017). https://doi.org/10.1007/s11726-017-1016-9
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DOI: https://doi.org/10.1007/s11726-017-1016-9
Keywords
- Acupuncture, Ear
- Hydro-acupuncture
- Point, Zusanli (ST 36)
- Shoulder Pain
- Laparoscopy
- Postoperative Complications
- Women