电针对全膝关节置换术后辅助镇痛的临床疗效观察

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 oper-ation,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 Zusānlǐ(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.Sepa-rately,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-α in 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 P＞0.05).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 P＜0.05).After treatment,SRSS score in the EA combination group was lower than that in the celecox group(P＜0.05).The expressions of IL-6 and TNF-α were reduced gradually in the two groups(all P＜0.05)and the values in the EA combination group were lower than the celecox group(P＜0.05).IL-10 was increased gradually(P＜0.05)and the value in the EA combination group was higher than the celecox group(P＜0.05).Conclusion:Electroacupuncture effectively alleviates pain induced by TKA and the curative effect is def-inite.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.