針刺放血減輕全身麻醉術後喉嚨疼痛之成效

Bloodletting Acupuncture Relieves Postoperative Sore Throat After General Anesthesia

李俞湘(Yu-Hsiang Lee)

指導教授 ： 高家常

義守大學/醫學院/醫務管理學系/碩士(2014年)

https://doi.org/10.6343/ISU.2014.00093

摘要

背景：針刺放血療法是傳統中國傳統醫學的重要一環。經全身麻醉後，利用針刺放血減輕病患術後喉嚨疼痛的效果則缺乏實證醫學的支持。
目的：探討針刺放血緩解接受氣管內管插管全身麻醉病患術後喉嚨疼痛的成效。
方法： 在南部一家地區教學醫院，以隨機分配方式將接受氣管內管插管全身麻醉病患分成實驗組(n=30)與對照組(n=30)兩組。兩組研究對象皆接受常規藥物治療，實驗組則在拔除氣管內管插管一分鐘內在少商、商陽和印堂穴，以26號針頭針刺放血。術前收集研究對象之個人基本資料與慢性疾病史，並以疼痛臉譜量表來收集術後的第一個1小時、3小時及6小時的主觀疼痛程度。資料利用卡方檢定及獨立樣本T檢定分析資料，以p <.05設定顯著水準，控制實驗組和控制組兩組的性別與年齡上。以重複測量變異數分析來檢測兩組在三次的疼痛程度之差異。
結果：與對照組病患相比，實驗組的患者在術後3小時和6小時的喉嚨疼痛緩解效果較為顯著。術後咽喉痛的緩解是由時間(F =128.133，p <0.001)，組別因素(F=10.518，p = 0.002)和時間與組別因素交互作用(F=14.008，p < 0.001)而造成。實驗組與控制組在性別、年齡、麻醉時間及慢性病症狀間並無顯著性差異。疼痛程度隨著術後氣管內管插管拔管的時間增加而趨於緩解。
結論與建議：本研究支持針刺放血是一種有效的術後喉嚨疼痛緩解的方式，可紓緩氣管內管插管全身麻醉病患術後喉嚨疼痛。應用針灸針刺放血於臨床實驗，將可以提升病患全身麻醉術後的護理品質及滿意度。

關鍵字

全身麻醉 ； 術後喉嚨疼痛 ； 針刺放血

並列摘要

Background：The evidence regarding the effect of bloodletting acupuncture on alleviating postoperative sore throat and discomfort for patients with general anesthesia with tracheal intubation is scarce.
Purpose：The purpose of the study was to examine the effect of bloodletting acupuncture on alleviating postoperative sore throat among patients with general anesthesia with tracheal intubation.
Methods：This was a quasi-experimental and longitudinal with randomized design. The participants, who received a surgery by means of tracheal intubation anesthesia, were randomly distributed into an experimental (E) group (n=30) and a control (C) group (n=30). Bloodletting was punched on the three areas：Shao Shang (少商, LU11), Shang Yang (商陽, LI1) and Ying Tang (印堂,Ex-HN3) within one minute after tracheal extubation for the E group. Participants of both groups received standard medications. Participants’ basic information (gender, age, period of anesthesia and history of chronic symptom, such as chronic chest pain, laryngeal problems, or asthma) were collected prior to the day of receiving the anesthesia by face to face interview. Wong-Backer FACES Pain Visual Questionnaire was used to collect the level of pain of participants at 1 hour, 3 hour, and 6 hour each after tracheal extubation. Descriptive statistics, Chi-square, t-tests, and two-way repeated measure ANOVA were used for analyzing the data. We set the significant level at p < .05.
Results： No significant differences in gender, age, and the duration of surgery and history of chronic symptoms between the E and C groups. The level of pain was decreased following by the 1 hour, 3 hour, and 6 hour after extracting endoscope for both TE and C groups. Compared with control group patients, experimental group patients reported significant low level of pain at the 3- and 6-hour respectively. Postoperative sore throat were relieving by time (F=128.133, p < 0.001), group (F=10.518, p = 0.002), and time interaction with group (F=14.008, p <0. 001).
Conclusion and implication for clinical practice：This study demonstrated that bloodletting acupuncture is an effective method for alleviating postoperative sore throat among patients with general anesthesia. Application bloodletting acupuncture to clinical practice may alleviate postoperative sore throat and discomfort that can enhance quality of care for patient with general anesthesia with tracheal intubation.

並列關鍵字

bloodletting acupuncture ； postoperative sore throat ； general anesthesia with tracheal intubation

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