皮内针联合腕踝针辅助纤维支气管镜检查的效果研究

doi:10.19983/j.issn.2096-8493.20260095

摘要/Abstract

摘要：

目的: 探究皮内针联合腕踝针在“超前镇痛”理念下辅助纤维支气管镜检查的效果。方法: 选取2023年1—7月于佛山市第二人民医院呼吸与危重症医学科病房行纤维支气管镜检查的120例患者为研究对象,采用随机数字表法将研究对象分为治疗组、对照组和安慰组,每组40例。比较三组检查前(T1)、纤维支气管镜过声门时(T2)、纤维支气管镜过声门后5min(T3)、检查结束后(T4)的生命体征、自评焦虑量表(SAS)评分、患者舒适度[视觉模拟评分量表1(VAS1)评分]、镜检医师满意度[视觉模拟评分量表2(VAS2)评分]及术后不良反应发生情况。结果: 重复测量方差分析显示,收缩压在三组间的差异有统计学意义(F=4.130,P=0.019),治疗组收缩压在T3、T4时点[分别为(132.51±15.47)mmHg和(131.20±17.69)mmHg;1mmHg=0.133kPa]较对照组[分别为(135.05±18.57)mmHg和(136.88±19.33)mmHg]和安慰组[分别为(141.73±16.82)mmHg和(145.45±21.02)mmHg]更平稳;三组间各时点心率差异也有统计学意义(F=3.850,P=0.024)。治疗组检查前后SAS评分下降[(42.61±8.49)分 vs. (40.95±6.42)分;t=2.010,P=0.050];对照组与安慰组检查前后SAS评分均明显上升。治疗组检查前后VAS1评分及VAS2评分均无明显变化,而对照组与安慰组检查前后VAS1和VAS2评分均明显下降。治疗组不良反应发生率为10.0%(4/40),明显低于对照组(42.5%,17/40)和安慰组(32.5%,13/40),差异有统计学意义(χ²=10.917,P=0.004)。结论: 皮内针联合腕踝针能稳定纤维支气管镜检查患者生命体征,减轻焦虑,提高患者舒适度与医师满意度,降低不良反应发生率。

关键词: 支气管镜检查, 针刺镇痛, 病人依从, 对比研究

Abstract:

Objective: To explore the adjuvant effect of intradermal needle combined with wristankle acupuncture under the concept of preemptive analgesia in patients undergoing fiberoptic bronchoscopy. Methods: A total of 120 patients undergoing fiberoptic bronchoscopy in the Department of Respiratory and Critical Care Medicine, Foshan Second People’s Hospital from January to July 2023 were enrolled. They were randomly divided into treatment group, control group, and sham acupuncture group, with 40 cases in each group. Vital signs, Selfrating Anxiety Scale (SAS) scores, patient comfort (Visual Analogue Scale 1, VAS1), physician satisfaction (Visual Analogue Scale 2, VAS2), and postoperative adverse reactions were compared at four time points: before examination (T1), passing the glottis (T2), 5 minutes after passing the glottis (T3), and after completion of examination (T4). Results: Repeatedmeasures analysis of variance showed significant differences in systolic blood pressure among the three groups (F=4.130, P=0.019). Systolic blood pressure in the treatment group at T3 and T4 ((132.51±15.47) mmHg and (131.20±17.69) mmHg; 1 mmHg=0.133 kPa) was more stable than that in the control group ((135.05±18.57) mmHg and (136.88±19.33) mmHg) and sham group ((141.73±16.82) mmHg and (145.45±21.02) mmHg). Heart rate also differed significantly among groups at all time points (F=3.850, P=0.024). SAS scores decreased significantly in the treatment group after examination (42.61±8.49 vs. 40.95±6.42; t=2.010, P=0.050), but increased markedly in the control and sham groups. VAS1 and VAS2 scores remained stable in the treatment group but decreased significantly in the other two groups. The incidence of adverse reactions in the treatment group was 10.0% (4/40), significantly lower than 42.5% (17/40) in the control group and 32.5% (13/40) in the sham group (χ²=10.917, P=0.004). Conclusion: Intradermal needle combined with wristankle acupuncture can stabilize vital signs, relieve anxiety, improve patient comfort and physician satisfaction, and reduce adverse reactions in patients undergoing fiberoptic bronchoscopy.

Key words: Bronchoscopy, Acupuncture analgesia, Patient compliance, Comparative study

中图分类号:

R562

卢南锦, 戴水燕, 黎佩文, 黄琨伦, 梁国明, 梁伟权, 陈绍森. 皮内针联合腕踝针辅助纤维支气管镜检查的效果研究[J]. 结核与肺部疾病杂志, 2026, 7(3): 302-307. doi: 10.19983/j.issn.2096-8493.20260095

Lu Nanjin, Dai Shuiyan, Li Peiwen, Huang Kunlun, Liang Guoming, Liang Weiquan, Chen Shaosen. Efficacy of intradermal needle plus wrist-ankle acupuncture for assisting fiberoptic bronchoscopy[J]. Journal of Tuberculosis and Lung Disease, 2026, 7(3): 302-307. doi: 10.19983/j.issn.2096-8493.20260095

图/表 7

表1

表2

表3

表4

表5

表6

表7

参考文献 21

[1]	范迪, 杨晨, 谢铜顺. 舒适护理对纤维支气管镜下介入治疗肺结核患者应对方式的影响. 中国现代医生, 2021, 59(25): 180-183.
[2]	李艳双. 针对性护理在肺炎患者临床治疗中的应用及其对预后的影响. 饮食保健, 2017, 4(6):190. doi:10.3969/j.issn.2095-8439.2017.06.229.
[3]	段娜, 韩芳, 黄华俊. 肺癌患者纤维支气管镜检查舒适度的影响因素. 癌症进展, 2020, 18(17):1821-1824. doi:10.11877/j.issn.1672-1535.2020.18.17.26.
[4]	李玉恒, 陈丽芳, 张桂兰, 等. 髋关节置换术后中医镇痛护理干预30例体会. 云南中医中药杂志, 2015, 36(12):99-100. doi:10.16254/j.cnki.53-1120/r.2015.12.046.
[5]	Hu JS. Acupuncture treatment of cough. J Tradit Chin Med, 2007, 27(3):233-235. pmid: 17955664
[6]	Suzuki M, Yokoyama Y, Yamazaki H. Research into acupuncture for respiratory disease in Japan: a systematic review. Acupunct Med, 2009, 27(2): 54-60. doi:10.1136/aim.2009.000471. pmid: 19502460
[7]	卢志霞, 杨丽, 刘敏肖, 等. 腕踝针减少老年患者无痛支气管镜检查丙泊酚应用剂量随机对照研究. 中国中西医结合杂志, 2022, 42(3):317-321. doi:10.7661/j.cjim.20211119.224.
[8]	敬勇君, 卢普敏, 陶武, 等. 皮内针治疗踝部骨折患者术前焦虑综合征的疗效观察. 中国实用医药, 2022, 17(24):31-35. doi:10.14163/j.cnki.11-5547/r.2022.24.008.
[9]	Nemoto MW, Nozaki-Taguchi N, Togasaki G, et al. New approach to relieving pain and distress during high-dose-rate intracavitary irradiation for cervical cancer. Brachytherapy, 2015, 14(5):642-647. doi:10.1016/j.brachy.2015.04.009. pmid: 26024785
[10]	李宗艳, 施雁, 陈静娟, 等. 癌症患者心理焦虑测评工具的研究进展. 淮海医药, 2021, 39(3):326-329. doi:10.14126/j.cnki.1008-7044.2021.03.037.
[11]	Crichton N. Visual analogue scale (VAS). J Clin Nurs, 2001, 10(5): 706.
[12]	Stahl DL, Richard KM, Papadimos TJ. Complications of bronchoscopy: A concise synopsis. Int J Crit Illn Inj Sci, 2015, 5(3): 189-195. doi:10.4103/2229-5151.164995. pmid: 26557489
[13]	李亚新, 邵红艳, 安艳涛, 等. 全身麻醉下纤维支气管镜检查患者围手术期饮食护理的循证实践. 中华护理杂志, 2023, 58(19): 2319-2325. doi:10.3761/j.issn.0254-1769.2023.019.002.
[14]	高寅秋, 李辛洁, 贾擎, 等. 皮内针疗法在疼痛治疗中的应用. 北京中医药, 2017, 36(4): 373-375. doi:10.16025/j.1674-1307.2017.04.028.
[15]	黄翠, 鄢燕, 许佳一. 腕踝针疗法对变异性咳嗽疗效观察. 光明中医, 2015, 30(7): 1473-1474. doi:10.3969/j.issn.1003-8914.2015.07.054.
[16]	Nolano M, Provitera V, Caporaso G, et al. Cutaneous innervation of the human face as assessed by skin biopsy. Anat, 2013, 222(2): 161-169. doi:10.1111/joa.12001.
[17]	Huang ST, Chen GY, Lo HM, et al. Increase in the vagal modulation by acupuncture at neiguan point in the healthy subjects. Am J Chin Med, 2005, 33(1): 157-164. doi:10.1142/S0192415X0500276X.
[18]	包月. 肉芽肿性乳腺炎病人换药期腕踝针镇痛护理干预模式的研究. 循证护理, 2022, 8(12): 1637-1640. doi:10.12102/j.issn.2095-8668.2022.12.013.
[19]	陈洪, 卢卫忠, 冉广文, 等. 皮内针缓解跟骨骨折术后疼痛的临床研究. 中国中医急症, 2021, 30(2): 261-264. doi:10.3969/j.issn.1004-745X.2021.02.020.
[20]	夏玉雪, 乔远静, 李丹丹, 等. 超前镇痛理念的应用研究进展. 护理研究, 2022, 36(10): 1831-1834. doi:10.12102/j.issn.1009-6493.2022.10.024.
[21]	Cabrini L, Gioia L, Gemma M, et al. Acupuncture for diagnostic fiberoptic bronchoscopy:a prospective,randomized, placebo-controlled study. Am J Chin Med, 2006, 34(3): 409-415. doi:10.1142/S0192415X06003941.

组别	例数	性别[例(构成比,%)]		年龄 (岁,$\bar{x}$±s)
组别	例数	男性	女性	年龄 (岁,$\bar{x}$±s)
治疗组	40	23(57.5)	17(42.5)	65.71±13.51
对照组	40	18(45.0)	22(55.0)	62.13±14.36
安慰组	40	18(45.0)	22(55.0)	61.95±13.85
统计检验值		χ²=0.327		F=0.852
P值		0.370		0.650

组别	收缩压 (mmHg)	心率 (次/min)	血氧饱和度 (%)	自评焦虑量表 (分)	视觉模拟评分量表1(分)	视觉模拟评分量表2(分)
治疗组	133.90±20.08	82.71±17.69	97.39±1.24	42.61±8.49	9.88±0.46	10.00±0.00
对照组	129.60±13.80	84.50±13.38	97.05±1.74	38.58±5.79	9.73±0.51	9.70±0.516
安慰组	130.55±13.27	92.48±17.35	97.30±1.74	40.18±6.21	9.55±0.68	9.63±0.63
F值	90.620	86.302	12.780	34.490	11.610	16.160
P值	0.740	0.350	0.690	0.260	0.020	0.003

指标	T1	T2	T3	T4	F_组间值	P值	F_时间值	P值	F_交互值	P值
收缩压(mmHg,$\bar{x}$±s)					4.130	0.019	8.760	<0.01	2.220	0.047
治疗组	133.90± 20.08	135.66± 17.58	132.51± 15.47	131.20± 17.69
对照组	129.60± 13.80	130.38± 15.44	135.05± 18.57	136.88± 19.33
安慰组	130.50± 13.27	135.98± 15.30	141.73± 16.82	145.45± 21.02
心率(次/min,$\bar{x}$±s)					3.850	0.024	7.920	<0.01	1.950	0.061
治疗组	82.71± 17.69	86.59± 15.98	85.80± 14.08	80.49± 12.51
对照组	84.50± 13.38	85.65± 11.48	86.00± 13.61	83.40± 14.13
安慰组	92.48± 17.35	93.08± 14.61	94.80± 15.60	92.55± 17.28
血氧饱和度(%,$\bar{x}$±s)					1.250	0.291	2.140	0.127	0.880	0.453
治疗组	97.39± 1.24	97.59± 1.05	97.63± 0.99	96.54± 2.15
对照组	97.05± 1.74	97.05± 1.26	96.18± 2.11	94.85± 3.39
安慰组	97.30± 1.74	96.43± 1.75	96.23± 1.78	95.38± 3.01

组别	检查前	检查后	t值	P值
治疗组	42.61±8.49	40.95±6.42	2.010	0.050
对照组	38.58±5.79	40.68±6.60	-3.440	0.001
安慰组	40.18±6.21	42.68±7.04	-3.220	0.003

组别	检查前	检查后	t值	P值
治疗组	9.88±0.46	9.83±0.54	0.470	0.643
对照组	9.73±0.51	9.01±0.99	4.970	<0.01
安慰组	9.55±0.68	8.85±1.08	5.190	<0.01
F值	11.610	13.096
P值	0.020	<0.01