针药结合治疗术后恶心呕吐疗效观察

Clinical observation on treating postoperative nausea and vomiting with integrating of acupuncture and medicine

关键词:  中西医结合  术后恶心呕吐  恩丹西酮  针刺  内关

Key words:  integrated traditional Chinese and Western medicine  postoperative nausea and vomiting(PONV)  ondansetron  acupuncture  NeiGuan(P6)

摘要:

[目的]比较单纯应用西药恩丹西酮和结合针刺内关穴治疗术后恶心呕吐(PONV)的效果。[方法]选择2006年3月—12月所有美国麻醉师学会评级(ASAⅠ～Ⅱ)级择期行盆腹腔非胃肠道手术病例,于麻醉后手术前静注恩丹西酮4mg,选取其中术后6h内主诉恶心呕吐的患者85例,随机分为两组,Ⅰ组(n=42)给予静脉注射恩丹西酮4mg同时针刺非穴位点,Ⅱ组(n=43)给予静脉注射恩丹西酮4 mg同时针刺双侧内关穴位点,观察两组的疗效。[结果]两组再次发作恶心呕吐的差异无统计学意义,但症状的分级差异有统计学意义,Ⅱ组低于Ⅰ组(P<0.05)。[结论]恩丹西酮结合针刺治疗手术后恶心呕吐效果好于单纯应用恩丹西酮静脉注射,值得推广。

Abstract:

[Objective] To evaluate and compare the curative effect of medicine alone and integration of acupuncture and medicine on treating postoperative nausea and vomiting(PONV).[Methods] All patients were undergone operation of celiac or peritoneal operation except gastro-intestinal operation and were received ondansetron 4 mg before the operation.The case was selected only if the patient complained about nausea and vomiting within 6 h after operation.Eight-five patients were selected and they were randomly divided into two groups: control and acupuncture group.In controls,the patients were injected with ondansetron 4 mg and were acupunctured at a non-acupoint site.In the acupuncture group,they were injected with ondansetron 4 mg and acupunctured at the P6 point simultaneously.The level of PONV thereafter was recorded and the clinical effect observed.[Results] The patients of acupuncture group had a lower level of PONV than that of control group.The incidence of PONV wasn’t significantly different between two groups.[Conclusions] Associated ondansetron with acupuncture at the P6 meridian point is more effective for the treatment of nausea and vomiting than using ondansetron alone.