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| 围术期颊针疗法对剖宫产产妇术后镇痛效果的影响 |
| Effect of perioperative buccal acupuncture therapy on postoperative analgesia in parturients undergoing cesarean section |
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| DOI：10.12089/jca.2026.06.009 |
| 中文关键词: 针刺 剖宫产术 疼痛 针刺镇痛 患者自控静脉镇痛 |
| 英文关键词: Acupuncture Cesarean section Pain Acupuncture analgesia Patient-controlled analgesia |
| 基金项目:广东省中医药局科研项目（20251286）；广西壮族自治区中医药管理局自筹经费科研课题（GXZYB20240946，GXZYB20240953） |
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| 中文摘要: |
目的：探讨围术期颊针疗法对剖宫产产妇术后镇痛效果与安全性的影响。
方法：选择择期行剖宫产产妇，产次≤3次，年龄20～40岁，BMI 18.5～40.0 kg/m2，ASA Ⅱ或Ⅲ级。采用随机数字表法将产妇分为两组：对照组和颊针组。颊针组在手术结束前30 min、术后第1天和第2天分别行颊针治疗，留针30 min。对照组不行颊针治疗。术毕两组产妇均通过硬膜外导管给予0.2%罗哌卡因8 ml，术后采用布托啡诺及曲马多行患者自控静脉镇痛（PCIA）。若30 min内按压镇痛泵2次后VAS疼痛评分＞3分，则采用双氯芬酸钠栓补救镇痛。主要指标为术后阿片类药物用量，即术后吗啡毫克当量（MME）总用量。次要指标包括镇痛泵有效按压次数和总按压次数，补救镇痛率及镇痛满意度，术后6、12、24、48 h静息时切口痛、活动时切口痛和宫缩痛的VAS疼痛评分，术后首次下床活动时间、首次肛门排气时间、拔除尿管后首次排尿时间。
结果：本研究共纳入产妇93例，对照组47例，颊针组46例。与对照组比较，颊针组术后MME总用量明显减少，镇痛泵有效按压次数和总按压次数明显减少，术后补救镇痛率明显降低，镇痛满意度明显升高，术后24 h静息切口痛VAS疼痛评分明显降低，术后24、48 h活动切口痛、宫缩痛的VAS疼痛评分明显降低，术后首次下床活动时间、首次肛门排气时间、拔除尿管后首次排尿时间明显缩短（P＜0.05）。
结论： 围术期颊针疗法能减少术后阿片类药物用量，改善剖宫产术后疼痛，促进产后恢复，提高舒适度。 |
| 英文摘要: |
Objective: To investigate the effect of perioperative buccal acupuncture therapy on postoperative analgesia and its safety in parturients undergoing cesarean section.
Methods: Parturients scheduled for elective cesarean section, with a parity ≤ 3 times, aged 20-40 years, BMI 18.5-40.0 kg/m2, and ASA physical status Ⅱ or Ⅲ were selected. The parturients were randomly divided into two groups using a random number table: control group and buccal acupuncture group. The buccal acupuncture group received buccal acupuncture treatment 30 minutes before the end of surgery, and on the first and second postoperative days, with needles retained for 30 minutes each time. The control group did not receive buccal acupuncture treatment. At the end of surgery, parturients in both groups received 8 ml of 0.2% ropivacaine via the epidural catheter. Postoperative analgesia was managed with patient-controlled intravenous analgesia (PCIA) using butorphanol and tramadol. If the VAS pain score was > 3 after two PCIA demands within 30 minutes, diclofenac sodium was administered for rescue analgesia. The primary outcome was the consumption of postoperative opioids, expressed as total postoperative morphine milligram equivalents (MME). Secondary outcomes included successful and total PCIA boluses postoperatively, rescue analgesia rate and analgesia satisfaction, VAS pain scores at rest and for evoked incisional pain and uterine contraction pain at 6, 12, 24, and 48 hours postoperatively, the time of the first activity after surgery, the time of the first anal exhaust, and the time of the first urination after removing the urinary catheter.
Results: Compared with the control group, the buccal acupuncture group showed a significant reduction in total MME postoperatively, a decrease in both the total number of analgesia pump presses and effective presses, a notable reduction in the postoperative analgesia rescue rate, a significant increase in analgesia satisfaction, a marked decrease in the VAS pain score for rest incision pain at 24 hours postoperatively, and significant reductions in VAS pain scores for induced incision pain and uterine contraction pain at 24 and 48 hours postoperatively, the buccal acupuncture group exhibited significantly shorter times for the first ambulation, the first anal exhaust, and the first urination after the removal of the urinary catheter (P < 0.05).
Conclusion: Perioperative buccal acupuncture can reduce postoperative opioids consumption and alleviate postoperative pain after cesarean section. It also promotes postoperative recovery and improves maternal comfort. |
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