耳穴压豆与腕踝针对经皮肾镜取石术后疼痛及睡眠质量影响的比较研究

摘要 目的：探讨腕踝针与耳穴压豆对经皮肾镜取石术（PCNL）后疼痛及睡眠质量的影响。方法：选取2019年8月至2020年5月就诊于我院接受PCNL干预的90例患者为研究对象，按随机数字法将患者随机分为A组（n=45）和B组（n=45）。A组行腕踝针治疗，B组行耳穴压豆治疗，均连续治疗3 d，比较两组视觉模拟疼痛评分（VAS）、术后不良反应、镇痛药物应用情况、匹兹堡睡眠质量指数（PSQI）积分等指标的差异。结果：两组术后1 h、12 h的VAS评分差异无统计学意义（P>0.05），A组术后24 h、48 h、72 h的VAS评分均低于B组，差异有统计学意义（P<0.05）。两组术后1 h和72 h均未使用曲马多，A组术后12 h、24 h、48 h曲马多应用率低于B组，差异有统计学意义（P<0.05）。A组头晕与呕吐发生率低于B组，差异有统计学意义（P<0.05），两组恶心发生率差异无统计学意义（P>0.05），两组不良反应总体发生率差异有统计学意义（P<0.05）。两组入院时PSQI总积分差异无统计学意义（P>0.05），A组治疗后PSQI总积分高于B组，差异有统计学意义（P<0.05）。结论：相较于耳穴压豆，腕踝针在缓解PCNL术后病人疼痛，降低术后不良反应与镇痛药物应用率方面更具优势。虽然腕踝针对PCNL术后病人睡眠无明显促进作用，但在临床镇痛中更具有效性与安全性。

Comparative Study on the Effect of Ear-point Pressing Beans and Wrist-ankle Acupuncture on Pain and Sleep Quality after Percutaneous Nephrolithotomy

ABSTRACT Objective: To investigate the effect of wrist-ankle acupuncture and ear-point pressing beans on pain and sleep quality after percutaneous nephrolithotomy (PCNL). Methods: 90 patients who received PCNL intervention in our hospital from August 2019 to may 2020 were randomly divided into group A (n = 45) and group B (n=45). A group was treated with wrist-ankle acupuncture and B group was treated with ear-point pressing beans for 3 consecutive days.The VAS score, postoperative adverse reactions, application of analgesic drugs and pittsburgh sleep quality index (PSQI) score were compared between the two groups. Results: There was no significant difference in VAS scores between the two groups at 1 h and 12 h after operation (P>0.05), but the VAS scores at 24 h, 48 h and 72 h in group A were lower than those in group B (P<0.05). Tramadol was not used in both groups at 1 h and 72 h after operation, and the application rate of tramadol in group A was lower than that in group B at 12 h, 24 h and 48 h after operation, and the difference was statistically significant (P<0.05). The incidence of dizzy and vomit in group A was lower than that in group B (P<0.05), but there was no significant difference in the incidence of nausea between the two groups (P>0.05), and there was significant difference in the overall incidence of adverse reactions between the two groups (P<0.05). The total score of the two groups was higher than that of the two groups (P<0.05). There was no significant difference in the total score of PSQI between the two groups at admission (P>0.05). After treatment, the total score of PSQI in group A was higher than that in group B (P<0.05). Conclusion: Compared with ear-point pressing beans, wrist- ankle acupuncture has more advantages in relieving pain, reducing postoperative adverse reactions and analgesic drug application rate. Although wrist-ankle acupuncture has no significant effect on sleep of patients after PCNL, it is more effective and safe in clinical analgesia.