Effect of Acupuncture at Zusanli(ST36)and Neiguan(PC6)on Analgesia and Serum Inflammatory Factors in Elderly Patients after Hip Replacement
Objective To explore the analgesic effect of acupuncture at Zusanli(ST36)and Neiguan(PC6)on elderly patients after hip replacement and its influence on serum inflammatory factors.Methods A total of 196 elderly patients undergoing total hip arthroplasty were selected as the research objects,and were divided into observation group and control group by random num-ber method.The control group was given routine symptomatic analgesia and cold compress after operation,and the observation group was given acupuncture at Zusanli(ST36)and Neiguan(PC6)on the basis of the control group 6 hours after operation.Pa-tients'pain status was evaluated by visual analogue scale(VAS)at 6 h,24 h,48 h,72 h and 5 d after operation,and postoperative flatulence was evaluated at 6 h,48 h and 72 h after operation.Serum inflammatory factors including prostaglandin E2(PGE2),interleukin-1 β(IL-1 β)and tumor necrosis factor-α(TNF-α)were detected at 6 h,24 h,48 h and 72 h after operation.Harris hip score was used to evaluate hip function before and 72 hours after operation and at discharge from the hospital.Results The VAS score was the highest in the two groups 24 hours after operation,and then gradually decreased(P＜0.05).After 48 hours,the VAS score of the observation group decreased 6 hours after operation,while that of the control group was still higher than that 6 hours after operation(P＜0.05).The VAS scores of the observation group were lower than those of the control group at 24 h,48 h,72 h and 5 d after operation(P＜0.05).After operation,the abdominal distension scores of both groups decreased gradually(P＜0.05).The abdominal distension score of the observation group was lower than that of the control group at 48 h and 72 h after operation(P＜0.05).Compared with those of the control group,the time for bowel sounds to appear and return to be normal,the time for first exhaust and defecation in the observation group were shorter(P＜0.05).The levels of PGE2,IL-1 βand TNF-α in the two groups were the highest at 24 h after operation,and gradually decreased at 72 h after operation(P＜0.05).The levels of PGE2,IL-1 β and TNF-α 5 days after operation in the observation group decreased to the levels at 6 hours after operation,while those in the control group were still higher than those at 6 hours after operation(P＜0.05).The lev-els of PGE2,IL-1β and TNF-α in observation group were lower than those in control group at 24 h,72 h and 5 d after opera-tion(P＜0.05).Harris hip score in both groups increased gradually after operation(P＜0.05).Harris hip score in the observa-tion group was higher than that in the control group 72 h after operation and at discharge(P＜0.05).Conclusion Acupuncture at Zusanli(ST36)and Neiguan(PC6)can better reduce the pain degree,shorten the pain time and promote the recovery of gastroin-testinal function in elderly patients after hip replacement,and its mechanism may be related to the reduction of inflammatory fac-tors such as PGE2,IL-1 β and TNF-α.
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