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篇名 運用針灸對於降低全膝關節置換術後疼痛之成效—系統性文獻回顧
卷期 29:4=104
並列篇名 The Effects of Acupuncture for Pain Relief After Total Knee Replacement: A Systematic Review
作者 柯幸芳蔣玉滿郭美玲
頁次 503-516
關鍵字 膝關節置換疼痛針灸total knee replacementpainacupuncture
出刊日期 201812
DOI 10.6386/CGN.201812_29(4).0001

中文摘要

背景:目前已有數篇探討運用針灸於降低全膝關節置換術後疼痛之研究,但其成效結果並未一致。 目的:確定針灸對於降低全膝關節置換術後疼痛之成效。 方法:以系統性文獻回顧法,使用「Acupuncture」、「Total knee Replacement」、「Pain」、「針 灸」、「全膝關節置換術」、「疼痛」等關鍵字搜尋2006 年1 月至2017 年6 月的中英文 資料庫包含The Cochrane Library、Science Direct、Embase、PubMed、CINAHL、台灣期刊 論文索引、台灣博碩士論文系統、中文電子期刊資料庫、中國期刊全文數據庫、萬芳數據 庫。文章選取標準為針灸介入降低全膝關節置換術後疼痛之隨機控制試驗。 結果:共得以10 篇進行分析整理,介入措施以耳穴療法或針刺療法為主。研究結果統整出(1) 耳 穴療法以神門、肺、皮質下及膝關節耳穴為主,針刺療法以血海、梁丘、犢鼻、內膝眼、 陽陵泉、足三里等穴位為主。(2) 耳穴療法每次按壓時間為3 分鐘,每天三至四次。(3) 電 針頻率以2 Hz 或10 至100 Hz 交替使用為主,每次時間為20 至30 分鐘,每天一次或每週 二次。 結論:針灸於全膝關節置換術鎮痛之臨床應用,可有效降低疼痛,發展穴位按壓標準作業流程, 能增加護理功能的獨特性。

英文摘要

Background: Several previous studies have investigated the effectiveness of acupuncture for pain relief after total knee replacement. However, the results of these studies are inconsistent. Purpose: We conducted a systematic review of studies evaluating the effectiveness of acupuncture for pain relief after total knee replacement. Methods: Electronic literature search of Cochrane Library, Science Direct, Embase, PubMed, CINAHL, Index to Taiwan Periodical Literature System, National Digital Library of Theses and Dissertations in Taiwan, Chinese Electronic Periodical Services, China Academic Journals Full-text Database, and Wanfang. Keywords that were used included: “acupuncture”, “total knee replacement”, “pain”. Studies were conducted between January 2006 to June 2017. We included all randomized controlled trials that compared acupuncture with standard care, evaluating pain relief outcomes in patients with total knee replacement. Studies were screened for inclusion criteria and non-Chinese or non-English language reports were excluded. Results: Of the 10 studies extracted, results supported the effectiveness of acupuncture for pain relief after total knee replacement. Intervention included auricular therapy and acupuncture based therapy. The results showed that (1) the commonly used auricular therapy points include Xi (AH4), Shenmen (TF4),Fei(CO14), Pizhixia (AT4), the main acupointsofXuehai(SP10), Liangqiu(ST34), Dubi(ST35), Neixiyan (EX-LE4), Yanglingquan (GB34) andZusanli (ST36); (2) auricular therapy each lasted 3 minutes and performed three to four times a day. (3) electro-acupuncture frequencies were used alternately at 2 Hz or 10 to 100 Hz for 20 to 30 minutes daily or twice per week. Conclusions: Developing a standard operating procedure in acupressure will not only improve the quality of clinical nursing care, but will also exude the unique function of nursing.

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