来源：风湿病与关节炎,2021,10（11）:13-16.

针刺四关穴配郄穴对全膝关节置换术后镇痛效果的临床研究（临床研究）

刘宗文，胡　力，童新延，苏尚贤

　　【摘　要】目的：观察针刺四关穴配郄穴在全膝关节置换术后的镇痛效果。方法：将40例行单侧全膝关节置换术的患者按照随机数字表法分为治疗组和对照组，每组20例。治疗组术后前3 d给予针刺双侧合谷、太冲、中都、梁丘，对照组术后前3 d给予氟比洛芬酯静脉滴注，余术后常规治疗均相同，手术由同一组术者完成。观察2组患者术后6，12，24，48，72 h的疼痛视觉模拟评分法（VAS）评分、术后首次追加镇痛药物情况及术后不良反应。结果：治疗组术后6，12，24，48 h疼痛VAS评分低于对照组，术后首次追加镇痛药物情况优于对照组，术后不良反应发生率低于对照组，差异均有统计学意义（P < 0.05）。结论：四关穴配郄穴在全膝关节置换术后早期具有良好的镇痛效果，能明显减少术后镇痛药物的使用及减少不良反应发生率。

　　【关键词】　四关穴；郄穴；全膝关节置换术；术后镇痛

Clinical Study on Analgesic Effect of Acupuncture at Siguan Point Combined with Xi Point After Total Knee Arthroplasty

LIU Zong-wen,HU Li,TONG Xin-yan,SU Shang-xian

　　【ABSTRACT】Objective:To observe the analgesic effect of acupuncture at Siguan point combined with Xi point after total knee arthroplasty.Methods:Forty patients undergoing unilateral total knee arthroplasty were randomly divided into a treatment group and a control group,with 20 cases in each group.On the first three days

after operation,the treatment group was given acupuncture on acupoints of both Hegu,Taichong,Zhongdu and Liangqiu,and the control group was given intravenous drip of flurbiprofen axetil.The other routine treatments were the same after operation,and the operation was completed by the operators of the same group.The VAS of pain at 6,12,24,48 and 72 h after operation,the situation of the first addition of analgesic drugs,and postoperative adverse reactions were observed.Results:The VAS of pain in the treatment group at 6,12,24 and 48 h after operation were lower than those in the control group.The first addition of analgesic drugs after operation was better than that in the control group.The incidence of postoperative adverse reactions was lower than that in the control group,and the difference was statistically significant（P < 0.05）.Conclusion:Siguan point combined with Xin point has a good analgesic effect in the early stage after total knee arthroplasty,which can significantly reduce the use of postoperative analgesic drugs,and reduce the incidence of adverse reactions.

　　【Keywords】 siguan point;Xin point;total knee arthroplasty;postoperative analgesia