比較針剌與病人自控式止痛對下背痛手術術後止痛之療效觀察

The Comparison Of Effects between Acupuncture and Patient Controlled Analgesia (PCA) on Postoperative Pain for Patients with Spinal Surgery

唐遠雲(Yuan-Yun Tang) ； 薛宏昇(Hong-Sheng Shiue) ； 蔡馥光(Fu-Kuang Tsai) ； 葉柏巖(Bo-Yan Yeh) ； 陳彥融(Yen-Lung Chen) ； 劉耕豪(Geng-Hao Liu) ； 尤紹雯(Shao-Wen You) ； 楊宗憲(Tsung-Hsien Yang) ； 鄭淑臻(Shu-Chen Cheng) ； 黃新家(Hsin-Chia Huang) ； 謝逸雯(Yi-Wen Hsieh)

《中醫藥雜誌》 29卷2期 (2018/12) Pp. 42-50

https://doi.org/10.3966/241139642018122902003

摘要

目的：為了比較針刺與PCA（patient controlled analgesia）對腰椎手術病人術後疼痛療效評估。方法：回溯收集2013年03月至2013年07月期間於長庚醫療財團法人林口長庚紀念醫院的腦神經外科住院中接受腰椎手術病患，以NRS（numeric rating scale）疼痛程度量表來進行術後疼痛評分。結果：PCA組在手術後第一天，手術後第二天，手術後第三天，手術後第四天，疼痛指數分別為3.13，3.67，3，2.8，術後第二天疼痛指數平均值高於術後第一天。而使用針刺組在手術後第一天，手術後第二天，手術後第三天，手術後第四天，疼痛指數分別降為3.83，3.29（P＜0.05），3.15（P＜0.05），和2.71（P＜0.05），但兩者止痛效果並沒有顯著差異。結論：針刺對術後疼痛的效果不亞於PCA，由於其操作簡單，安全性好，在臨床上值得應用與推廣。

關鍵字

針刺 ； PCA ； 腰椎手術 ； 手術後疼痛

並列摘要

Background: To compare the analgesic efficacy of acupuncture versus patient controlled analgesia (PCA) in the treatment of low back pain for post spine surgery. Method: We reviewed the medical records of the hospitalized patients with diagnosis of low back pain for post spine surgery in neurosurgery ward of Chang Gung Memorial Hospital, Linkou Branch, from March 2013 to July 2013. The clinical profiles included general characteristics and pain assessment was made using NRS (numeric rating scale). Result: The patients pain score for PCA group increased from 3.13 to 3.67 (P＞0.05) at postoperatively during the second day compared to the first day. The pain score for the acupuncture group decreased from 3.83 to 3.29 (P＜0.05), 3.15 (P＜0.05) and 2.71 (P＜0.05) at postoperatively during the second day, third day, and forth day, respectivively. But the difference between the two groups was not significant. Conclusion: The effectiveness of acupuncture for pain after spinal surgery is not inferior to PCA. Owing to its safety and simplicity, it is worth of further application and dissemination.

並列關鍵字

Acupuncture ； PCA ； Spinal surgery ； Postoperative pain

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