| Objective:To observe the clinical efficacy of injection of neostigmine at Zusanli point in treating abdominal distension and constipation after lumbar fracture surgery,and the therapeutic effect was compared with that of acupuncture at Zusanli and intramuscular injection of neostigmine.We will evaluate its application value and so as to provide scientific guidance and objective basis for future clinical application.Methods: From February 2020 to February 2021,60 patients with lumbar fracture after surgery in the Spinal Surgery Department of Fuzhou No.2 Hospital were selected according to the inclusion criteria.According to registration order,the patients were randomly divided into3 groups:treatment group(n=20): Zusanli acupoint acupuncture + point-injection of neostimine;Drug control group(n=20): intramuscular injection of neostigmine;Acupoint control(n=20): acupuncture bilateral Zusanli.Symptom scores before and after treatment,the first voluntary exhaust time and the first voluntary defecation time of 60 patients were recorded respectively.SPSS20.0 software was used for statistical analysis.Results:Except for one patient in the drug control group and one patient in the acupoint control group who withdrew from the study after using topical laxatives,all the other patients successfully completed this study according to the treatment plan.1.Baseline data comparison: there was no statistical significance in gender,age,injured vertebra,operation time,blood loss and treatment start time between the three groups(P>0.05).2.The first time of autonomous exhaust after intervention(T1):The time(T1)of treatment group was significantly shorter than that of drug control group and acupoint control group,and the difference is statistically significant(P<0.05).The time(T1)of drug control group was significantly shorter than that of acupoint control group(P<0.05).Suggesting that acupoint injection of neostigmine is better than drug injection alone or acupuncture alone in promoting exhaust.3.The time of the first voluntary defecation after intervention(T2):The time(T2)of treatment group was significantly shorter than that of drug control group and acupoint control group,and the difference is statistically significant(P<0.05).There was no statistical significance between drug control group and acupoint control group(P>0.05),suggesting that the acupoint injection of neostimine had a better effect on promoting defecation than drug injection alone or acupuncture alone.4.Abdominal distension and constipation symptom score: there was no significant difference in symptom score among the three groups before treatment.After treatment,the symptom scores of the three groups decreased significantly.The score of the treatment group was lower than that of the other two groups(P<0.05),and there was no significant difference between the drug control group and the acupoint control group after treatment(P>0.05).Suggesting that neostigmine injection at acupoint is considered to have the best effect on relieving symptoms.5.Safety observation: during the treatment,there were no needle fainting,infection of acupuncture site,drug allergy and aggravation of symptoms in the three groups.Conclusion: On the basis of needling response,the combination of Zusanli and neostigmine can significantly improve the symptoms of abdominal distension and constipation after lumbar fracture surgery,and promote ventilation and defecation of patients with lumbar fracture after surgery.The therapeutic effect is better than that of neostigmine injection alone or Zusanli acupoint acupuncture alone,without obvious adverse reactions. |
