| Objective To investigate the relationship between the application of auricular point sticking and the enhanced recovery after total knee arthroplasty,the value of the auricular acupoints in the enhanced recovery after total knee arthroplasty,and the statistical analysis of the factors related to the enhanced recovery,and clarify the effect of each factor on the enhanced recovery after total knee arthroplasty.Methods Study for randomized controlled clinical studies.All patients underwent total knee arthroplasty with unilateral severe osteoarthritis.Were randomly divided into a rapid recovery group,rapid rehabilitation group,auricular acupoint group,conventional group.Patients underwent surgery by the same chief physician to complete the same brand of imported fixed platform surface knee replacement,prosthesis are fixed with bone cement.Ear ear by the same physician to complete.Auricular rapid rehabilitation group:three days before surgery to give ear acupoints,perioperative implementation of rapid rehabilitation program.Rapid Rehabilitation Group:Perioperative implementation of rapid rehabilitation program.Auricular common group:three days before surgery to give ear acupressure,perioperative implementation of the general program.Routine group:Perioperative implementation of conventional programs.Postoperative questionnaire survey and data analysis were done by third parties,excluding subjective factors.Observed indicators include:(1)the prognosis of arthritis:the University of Western Ontario and McMaster University(WOMAC)osteoarthritis index,knee activity(Range of motion,ROM)to 30°,60°,90° required.(2)pain:postoperative pain visual analogue score VAS;(3)anxiety and insomnia:Hamilton Anxiety Scale(HAMA)score,Pittsburn Sleep Quality Index(PSQI)scale;(4)adverse events:Postoperative gastrointestinal adverse reaction rate.Epidata3.1 data management software for electronic data entry,and further use SPSS22.0 software for statistical analysis.Results 6 hours after surgery(P<0.01).Compared with the conventional group,there were significant differences between the two groups(P>0.05).The difference between the two groups was statistically significant(P<0.01).Compared with the conventional group,there were significant differences between the two groups(P>0.05)Statistically significant(P<0.05).There was significant difference between the two groups(P<0.05).The difference between the two groups was statistically significant(P<0.05).12 hours after surgery,analgesic effect of ear acupuncture combined with rapid rehabilitation of the best,rapid rehabilitation group is better than the ear group,ear group is better than the conventional group.24 hours after the VAS score between the comparison,using LSD method for comparison between the two.(P<0.05).Compared with the other three groups,the difference was statistically significant(P<0.05);but the ear acupuncture group and the other three groups were statistically significant(P<0.05)Comparison,the difference was not statistically significant.There were significant differences between the VAS scores and the LSD method at 48 h after operation(P<0.05).72 days after the VAS score between the comparison,using LSD method for comparison between the two.(P<0.01).The difference between the two groups was statistically significant(P<0.01).There was significant difference between the rapid rehabilitation group and the acupoint group and the conventional group(P<0.01).However,there was no significant difference between the ear acupuncture group and the rapid rehabilitation group and the rapid rehabilitation group compared with the conventional group.There was no significant difference in analgesic effect between the two groups at 72 hours after operation.At 6 h after operation,the changes of VAS scores were compared by LSD method.(P<0.01).Compared with the other three groups,the difference of VAS score between the two groups was compared by LSD method.(P<0.01).There was significant difference between the rapid rehabilitation group and the acupoint group and the conventional group(P<0.01),but the ear acupuncture group was significantly higher than that in the acupoint group and the conventional group(P<0.01)There was no significant difference between the rehabilitation group and the rapid rehabilitation group compared with the conventional group.24 days after the VAS score changes between the two groups were compared using LSD method.(P<0.01).There was significant difference between the rapid rehabilitation group and the acupoint group and the conventional group(P<0.01),but the ear acupuncture group was significantly higher than that in the acupoint group and the conventional group(P<0.01)There was no significant difference between the rehabilitation group and the rapid rehabilitation group compared with the conventional group.48 days after the VAS score changes between the groups using LSD method for comparison between the two.(P<0.01).There was significant difference between the rapid rehabilitation group and the acupoint group and the conventional group(P<0.01),but the ear acupuncture group was significantly higher than that in the acupoint group and the conventional group(P<0.01)There was no significant difference between the rehabilitation group and the rapid rehabilitation group compared with the conventional group.The difference of VAS score between the two groups was compared by LSD method.(P<0.01).There was significant difference between the rapid rehabilitation group and the acupoint group and the conventional group(P<0.01);the ear acupoint group and the conventional group(P<0.01),the difference was statistically significant(P<0.01)(P<0.05).However,there was no significant difference between the ear acupuncture group and the rapid rehabilitation group and the rapid rehabilitation group(P<0.05).VAS score interaction,postoperative 6h,72h,rapid recovery and ear acupoints interact.The LSD method was used to compare the PSQI scores between the two groups.There were significant differences between the four groups(P<0.05).There was a comparison between the PSQI score group and the LSD method.There was significant difference between the four groups(P<0.05).PSDI scores were compared between the two groups after LSD method.There were significant differences between the four groups(P<0.01).The changes of PSQI scores between the two groups were compared by LSD method.(P<0.01).There was significant difference between the rapid rehabilitation group and the acupoint group and the conventional group(P<0.01).The acupoint group and the conventional group had significant difference(P<0.01)(P<0.05).However,there was no significant difference between the ear acupuncture group and the rapid rehabilitation group and the rapid rehabilitation group,the difference between the ear acupuncture group and the conventional group was not statistically significant.The difference of PSQI scores between the two groups was compared by LSD method.There were significant differences between the four groups(P<0.05).The postoperative 3d PSQI score was compared between the two groups by LSD method.There were significant differences between the four groups(P<0.01).In this study,the gastrointestinal tract adverse reactions were compared by Bonfferoni method:ear acupuncture group+rapid rehabilitation group vs rapid rehabilitation group:no statistically significant;ear acupuncture group+rapid rehabilitation group vs ear group:no statistically significant;(P=0.001);rapid rehabilitation group vs ear acupuncture group:no statistically significant;rapid rehabilitation group vs conventional group:no statistically significant;ear group vs group:Statistical significance(p=0.003).There was a comparison between the HAMA scale and the LSD method.The difference between the two groups was statistically significant(P<0.05).The correlation between HAMA scale and postoperative WOMAC score was analyzed.ROM to 30° the time required to compare between groups,I statistically different.ROM to 60° for the time required for comparison between groups(days)using LSD method for two comparison.There was no significant difference between the ear hearing group and the rapid rehabilitation group and the rapid rehabilitation group(P<0.01).ROM to 90° of the time between the comparison between groups(days)using LSD method for two comparison.There were significant differences between the four groups(P<0.01).Conclusion Auricular point sticking in the knee surgery for perioperative period for analgesic,anxious,improve sleep,reduce gastrointestinal adverse reactions have a good effect,and auricular point sticking combined with enhanced recovery program can produce a good synergistic effect,you can enhanced recovery program of a useful supplement,because of its cheap and noninvasive significance of clinical promotion. |
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