【摘要】 目的观察耳穴贴压疗法缓解剖宫产术后疼痛的效果及对血清皮质醇、白细胞介素-6(IL-6)浓度的影响。方法选取108例择期行剖宫产手术产妇,随机分为3组,每组36例。A组采用静脉自控镇痛方式、B组采用耳穴贴压、C组采用耳穴贴压加静脉自控镇痛方式,均连续干预2d。记录3组各时段切口痛(包括静息痛和翻身痛)程度和催产素治疗时的宫缩痛程度;于术晨、术后第2天晨观察血清皮质醇、白细胞介素6(interleukin-6,IL-6)浓度。结果各时段A、B两组的切口痛差异无统计学意义(P>0.05),B组宫缩痛程度低于A组(P<0.05);C组切口痛(除术后48h)、宫缩痛程度均低于A、B两组(P<0.05)。术后第2天晨,A、B两组的血清皮质醇、IL-6浓度差异无统计学意义(P>0.05),C组低于A、B两组(P<0.05)。3组术后第2天晨血清皮质醇浓度均高于术晨(P<0.01);A、B组术后第2天晨血清IL-6浓度均高于术晨(P<0.05),而C组略低于术晨(P>0.05)。产妇切口痛评分与皮质醇浓度呈高度相关(r=0.775,P<0.01),与血清IL-6浓度呈中度相关(r=0.599,P<0.01)。结论耳穴贴压疗法能缓解剖宫产术后切口痛和宫缩痛,与血清皮质醇、IL-6浓度的下降有一定相关性。更多还原

【Abstract】 Objective To observe the analgesic effect of auricular point sticking after cesarean section and influences on serum cortisol and interleukin-6(IL-6).Methods One hundred and eight puerperae receiving cesarean section were randomly divided into 3 groups and 36 in each group.Group A received patient-controlled intravenous analgesia(PCIA),group B received auricular point sticking,and group C received both auricular point sticking and PCIA.The intervention lasted 2 days for all the 3 groups.The degree of incision pain(including rest pain and pain evoked by changing position in bed) at different times and uterine cramping pain when the oxytocin infused was evaluated by visual analogue scale(VAS).The concentration of serum Cor and IL-6 was measured in the morning of the cesarean section day and 2 days later after the cesarean section.Results The VAS scores of uterine cramping pain of group B was lower than that of group A(P<0.05),while there was no significant difference in incision pain between these two groups(P>0.05).Both the incision pain and uterine cramping pain of group C were significantly lower(P<0.05) than those of other two groups.The concentration of Cor and IL-6 of the group B and the group A were not significantly different(P>0.05) in the second morning after cesarean section,while those of group C was lower than other two groups(P<0.05).The concentration of Cor of each group was significantly higher(P<0.01) in the second morning after cesarean section than that in the morning of the cesarean section day in all groups.For group A and group B,the concentration of IL-6 was significantly higher(P<0.05) in the second morning after cesarean section than that in the morning in the cesarean section day,while the concentration of IL-6 for the group C changed without statistically significant(P>0.05).The incision pain was highly related to Cor(r=0.775,P<0.01) and moderately correlated to IL-6(r=0.599,P<0.01).Conclusion The auricular point sticking could relive incision pain and uterine cramping pain after cesarean section,which has some correlation with the decrease of concentration of serum Cor and IL-6.更多还原