揿针对胃内镜黏膜下剥离术后镇痛的疗效研究OA

Objective To evaluate whether combining thumb-tack needle treatment with routine nursing can safely reduce pain after gastric endoscopic submucosal dissection(ESD).Methods Seventy-eight patients after gastric ESD were randomized into an intervention group(n=39)and a control group(n=39),with 2 cases drop-off in the intervention group.Patients in the control group received postoperative conventional treatment.Patients in the intervention group received thumb-tack needle therapy at bilateral Zusanli(ST36)and Hegu(LI4)acupoints within 1 h after surgery in addition to conventional treatment,which lasted for 72 h.The primary outcome was the incidence of moderate-to-severe pain(visual analog scale[VAS]score≥4)within 72 h after surgery.The secondary outcomes included pain intensity,analgesic usage rate,anxiety/depression score,numbers of gastrointestinal symptoms,surgery-related complications,and treatment-related adverse events.Results The incidence of moderate-to-severe pain was 21.6%(8/37)in the intervention group,significantly lower(absolute difference:-24.6%;OR:0.322;95%CI:0.118-0.879;P<0.05)than that in the control group(46.2%[18/39]).Compared with the control group,the intervention group showed reduced scores in the Short-Form McGill Pain Questionnaire at the 6th,12th,and 24th hour after surgery(P<0.01),and the median VAS score decreased by 2-3 points compared to the control group(P<0.01,P<0.001).No statistical differences were observed between the two groups in analgesic usage rate,anxiety/depression score,numbers of gastrointestinal symptoms or surgery-related complications.Two patients(5.4%)removed the needles prematurely due to psychological reasons,which did not affect clinical outcomes.Conclusion Thumb-tack needling therapy can effectively reduce the incidence of moderate-to-severe pain after gastric ESD and improve early postoperative pain symptoms,with a favorable safety profile.