国际麻醉学与复苏杂志   2014, Issue (7): 8-8
    
针刺复合星状神经节阻滞治疗外伤性上肢截肢术后幻肢痛效果观察
龚琴1()
1.佛山市中医院
The effect of combination therapy of nerve block and acupuncture for phantom limb pain by amputation of upper extremity after surgery
 全文:
摘要:

目的:研究探讨针刺复合神经阻滞治疗上肢截肢术后幻肢痛的疗效。方法 80例上肢幻肢痛患者随机分为四组,每组20例,分别为基本治疗组(A组);针刺+基本治疗组(B组);神经阻滞+基本治疗组(C组);神经阻滞+针刺+基本治疗组(D组)。治疗前后分别采用VAS、SR-36和综合疗效评估,并分别进行治疗前后和组间比较。结果 四组患者治疗前后VAS评分及SF-36评分均有显著性差异(P﹤0.05),治疗后VAS评分降低,SF-36评分明显升高;与A相比,B组、C组、D组治疗后VAS评分明显降低,SF-36评分明显升高,其差异具有统计学意义(P﹤0.05);与B组、C组相比,D组治疗后VAS评分明显降低,SF-36评分明显升高,其差异具有统计学意义(P﹤0.05)。四组患者综合疗效比较:治疗5周后,与A相比,B组、C组、D组的综合疗效差异具有统计学意义(P﹤0.05),提示B组、C组、D组疗效优于A组,D组疗效优于B组和C组。结论 采用基本药物和心理治疗联合交感神经阻滞治疗、针刺治疗的中西结合治疗方案能明显提高上肢截肢术后的幻肢痛的疗效,改善患者的生活质量。

关键词: 幻肢痛 针刺 神经阻滞 星状神经节
Abstract:

Objective: To investigatethe effect of combination therapy of nerve block and acupuncture to phantom limb pain of upper extremity after amputation . Methods 80 patients with phantom limb pain of upper limb were randomly divided into four groups (n=20),20 patients received basic treatment (A group ),basic treatment included Medications and Psychotherapy ; 20 patients recieved acupuncture and basic treatment (B group) ; 20 patients recieved nerve block and basic treatment (C group ) ; 20 patients recieved nerve block、 acupuncture and basic treatment (D group ) . Scores of VAS 、 SR-36 and comprehensive comparison of efficacy were used to assess before and after treatment,and respectively Compared between before treatment and after treatment , or among the four groups . Results VAS scores and SF-36 scores of four groups of patients were significant differences after treatment compared with before treatment(P <0.05), VAS scores decreased after treatment , SF-36 scores were significantly increased ; compared with A group, VAS scores of B group、C group and D after treatment decreased significantly,and the differences were statistically significant (P <0.05); compared with B group and C group , VAS scores decreased of D group decreased significantly after treatment,and SF-36 scores were significantly increased ,the difference was statistically significant (P <0.05). Comprehensive comparison of efficacy of four groups of patients : After treat for 5 weeks, compared with the A, there was significant difference in comprehensive comparison of efficacy of B group、C group and D (P <0.05),this means that the treatment effect of B group、C group and D group is better than A group, the treatment effect of D group is best among four groups . Conclusion The use of basic drug and psychology therapy combined with sympathetic blockade therapy and acupuncture treatment can significantly improve the treatment effect of phantom limb pain of upper limb after amputation, improve the patient's quality of life.

Key words: phantom limb pain ;acupuncture;nerve block; Stellate ganglion