Acupuncture in the Treatment of Postoperative Nausea and Vomiting: A Report of One Case and Review of Related Literature_West China Medical Journal

Authors：

LUuml , Jianqin ,  PAN Hui

Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

PAN Hui, Email: 372651647@qq.com

Keywords：

针刺; 术后恶心呕吐; 防治疗效

DOI：

10.7507/1002-0179.20130543

Video：

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目的　探讨针刺治疗在防治术后恶心呕吐（PONV）中的作用与疗效。方法　通过对2012年6月收治的1例全身麻醉下行小脑血肿清除术后出现持续性恶心呕吐症状，后辅以针刺治疗好转的病例报道，就针刺治疗对PONV的穴位选择，刺激方式，介入时间等相关研究进行复习和总结。结果　患者恶心呕吐症状在选取中脘、足三里（双）、内关（双）穴针刺治疗3次后（30 min/次）明显减少，自诉恶心程度较前缓解，连续针灸6次后呕吐现象得到有效控制。结论　目前有关针刺治疗PONV的研究越来越多，但尚无统一的治疗标准。

Citation： LUuml,Jianqin,PAN Hui,LI Ning.. Acupuncture in the Treatment of Postoperative Nausea and Vomiting: A Report of One Case and Review of Related Literature. West China Medical Journal, 2013, 28(11): 1726-1730. doi: 10.7507/1002-0179.20130543 Copy

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2.	Irefin SA, Schubert A, Bloomfield EL, et al. The effect of craniotomy location on postoperative pain and nausea[J]. J Anesth, 2003, 17(4): 227-231.
3.	Latz B, Mordhorst C, Kerz T, et al. Postoperative nausea and vomiting in patients after craniotomy: incidence and risk factors[J]. J Neurosurg, 2011, 114(2): 491-496.
4.	Gan TJ. Postoperative nausea and vomiting-can it be eliminated?[J]. JAMA, 2002, 287(10): 1233-1236.
5.	Kovac AL. Prevention and treatment of postoperative nausea and vomiting[J]. Drugs, 2000, 59(2): 213-243.
6.	Couture DJ, Maye JP, O’brien D, et al. Therapeutic modalities for the prophylactic management of postoperative nausea and vomiting[J]. J Perianesth Nurs, 2006, 21(6): 398-403.
7.	White PF. Consensus guidelines for managing postoperative nausea and vomiting: is there a conflict of interest?[J]. Anesth Analg, 2004, 98(2): 550-551.
8.	Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting:a review[J]. Can J Anaesth, 2004, 51(4): 326-341.
9.	Nunley C, Wakim J, Guinn C. The effects of stimulation of acupressure point p6 on postoperative nausea and vomiting: a review of literature[J]. J Perianesth Nurs, 2008, 23(4): 247-261.
10.	Kotani N, Hashimoto H, Sato Y, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses[J]. Anesthesiology, 2001, 95(2): 349-356.
11.	Rusy LM, Hoffman GM, Weisman SJ. Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy[J]. Anesthesiology, 2002, 96(2): 300-305.
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18.	Alkaissi A, Evertsson K, Johnsson VA, et al. P6 acupressure May relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women[J]. Can J Anaesth, 2002, 49(10): 1034-1039.
19.	Alkaissi AE, Stålnert M, Kalman S. Effect and placebo effect of acupressure(P6) on nausea and vomiting after outpatient gynaecological surgery[J]. Acta Anaesthesiol Scand, 1999, 43(3): 270-274.
20.	Streitberger K, Diefenbacher M, Bauer A, et al. Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial[J]. Anaesthesia, 2004, 59(2): 142-149.
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1. 　Macario A, Weinger M, Carney S, et al. Which clinical anesthesia outcomes are important to avoid? The perspective of patients[J]. Anesth Analg, 1999, 89(3): 652-658.
2. 　Irefin SA, Schubert A, Bloomfield EL, et al. The effect of craniotomy location on postoperative pain and nausea[J]. J Anesth, 2003, 17(4): 227-231.
3. 　Latz B, Mordhorst C, Kerz T, et al. Postoperative nausea and vomiting in patients after craniotomy: incidence and risk factors[J]. J Neurosurg, 2011, 114(2): 491-496.
4. 　Gan TJ. Postoperative nausea and vomiting-can it be eliminated?[J]. JAMA, 2002, 287(10): 1233-1236.
5. 　Kovac AL. Prevention and treatment of postoperative nausea and vomiting[J]. Drugs, 2000, 59(2): 213-243.
6. 　Couture DJ, Maye JP, O’brien D, et al. Therapeutic modalities for the prophylactic management of postoperative nausea and vomiting[J]. J Perianesth Nurs, 2006, 21(6): 398-403.
7. 　White PF. Consensus guidelines for managing postoperative nausea and vomiting: is there a conflict of interest?[J]. Anesth Analg, 2004, 98(2): 550-551.
8. 　Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting:a review[J]. Can J Anaesth, 2004, 51(4): 326-341.
9. 　Nunley C, Wakim J, Guinn C. The effects of stimulation of acupressure point p6 on postoperative nausea and vomiting: a review of literature[J]. J Perianesth Nurs, 2008, 23(4): 247-261.
10. 　Kotani N, Hashimoto H, Sato Y, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses[J]. Anesthesiology, 2001, 95(2): 349-356.
11. 　Rusy LM, Hoffman GM, Weisman SJ. Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy[J]. Anesthesiology, 2002, 96(2): 300-305.
12. 　American Society of PeriAnesthesia Nurses PONV/PDNV Strategic Work Team. ASPAN’S evidence-based clinical practice guideline for the prevention and/or management of PONV/PDNV[J]. J Perianesth Nurs, 2006, 21(4): 230-250.
13. 　刘伟, 赵民, 祝力群, 等. 术后恶心呕吐相关因素的临床调查分析[J]. 中国医师进修杂志, 2007, 30(3): 42-43.
14. 　吴会生, 刘丹彦. 术后恶心呕吐(PONV)的风险因素及防治[J]. 医学教育探索, 2008, 7(8): 888-891.
15. 　李宝贵, 陶富盛. 术后恶心呕吐的中西医认识和临床对策[J]. 辽宁中医药大学学报, 2011(2): 135-138.
16. 　李学斌, 王会文, 张雪梅, 等. 颅脑手术麻醉后恢复室常见并发症[J]. 中国康复理论与实践, 2010, 16(5): 489-491.
17. 　宋先荣, 张咸虎, 程学敏. 术后恶心呕吐相关因素的临床调查[J]. 中华全科医学, 2008, 6(7): 730-731.
18. 　Alkaissi A, Evertsson K, Johnsson VA, et al. P6 acupressure May relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women[J]. Can J Anaesth, 2002, 49(10): 1034-1039.
19. 　Alkaissi AE, Stålnert M, Kalman S. Effect and placebo effect of acupressure(P6) on nausea and vomiting after outpatient gynaecological surgery[J]. Acta Anaesthesiol Scand, 1999, 43(3): 270-274.
20. 　Streitberger K, Diefenbacher M, Bauer A, et al. Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial[J]. Anaesthesia, 2004, 59(2): 142-149.
21. 　徐韶怡, 郑士立, 王庆来, 等. 耳穴针刺贴压对妇科术后恶心呕吐的抑制作用疗效观察[J]. 针刺研究, 2009, 34(2): 143-144.
22. 　刘焱红, 于辉, 王博, 等. 经皮穴位电刺激对女性乳腺癌术后恶心呕吐的影响[J]. 中国中医药科技, 2011, 18(1): 67-68.
23. 　裴英, 胡明, 王丽霞, 等. 针刺预防术后恶心呕吐的临床观察[J]. 新疆中医药, 2010, 28(4): 36-37.
24. 　欧阳铭文, 秦再生, 林春水, 等. 针刺对腹腔镜术后恶心、呕吐的预防作用[J]. 中国针灸, 2009, 29(11): 915-918.
25. 　彭小兰, 李政文, 吕黄勇, 等. 穴位敷葱缓解内镜下黏膜剥离术后恶心呕吐的疗效观察[J]. 西南国防医药, 2011, 21(7): 754-755.
26. 　刘志顺, 于金娜, 张瑞锋, 等. 电针内关穴防治胃镜检查不良反应的疗效和安全性评价[J]. 北京中医, 2007, 26(1): 18-20.
27. 　Xu M, Zhou SJ, Jiang CC, et al. The effects of P6 electrical acustimulation on postoperative nausea and vomiting in patients after infratentorial craniotomy[J]. J Neurosurg Anesthesiol, 2012, 24(4): 312-316.
28. 　Wang SM, Kain ZN. P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children[J]. Anesthesiology, 2002, 97(2): 359-366.
29. 　Butkovic D, Toljan S, Matolic M, et al. Comparison of laser acupuncture and metoclopramide in PONV prevention in children[J]. Paediatr Anaesth, 2005, 15(1): 37-40.
30. 　姜玲. 穴位按压缓解甲状腺术后恶心呕吐66例效果观察[J]. 齐鲁护理杂志, 2012, 18(5): 3.
31. 　唐敏芳, 严闪红. 穴位按压对甲状腺术后呕吐的防治效果观察[J]. 中外健康文摘, 2011, 8(22): 438-438.
32. 　许占宏, 董全玲, 王国年, 等. 韩氏穴位神经刺激仪对甲状腺术后的影响[J]. 哈尔滨医科大学学报, 2005, 39(4): 364-366.
33. 　商军科, 杨志光, 薛丽. 针刺对62例硬膜外阻滞下行腹部手术后胃肠功能恢复的影响[J]. 陕西中医, 2001, 22(7): 416.
34. 　戈宏焱, 陈博, 李有田. 针刺对肾移植术后患者胃肠道反应的影响[J]. 中国针灸, 2008, 28(3): 177-178.
35. 　冯璐, 王君. 针药结合治疗术后恶心呕吐疗效观察[J]. 天津中医药, 2008, 25(2): 108-110.
36. 　袁素洁. 穴位按摩在缓解骨科术后恶心呕吐中的应用体会[J]. 天津护理, 2012, 20(2): 106.
37. 　Habib AS, Itchon-Ramos N, Phillips-Bute BG, et al. Transcutaneous acupoint electrical stimulation with the ReliefBand for the prevention of nausea and vomiting during and after cesarean delivery under spinal anesthesia[J]. Anesth Analg, 2006, 102(2): 581-584.
38. 　Harmon D, Gardiner J, Harrison R, et al. Acupressure and the prevention of nausea and vomiting after laparoscopy[J]. Br J Anaesth, 1999, 82(3): 387-390.
39. 　Agarwal A, Pathak A, Gaur A. Acupressure wristbands do not prevent postoperative nausea and vomiting after urological endoscopic surgery[J]. Can J Anaesth, 2000, 47(4): 319-324.
40. 　Harmon D, Ryan M, Kelly A, et al. Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section[J]. Br J Anaesth, 2000, 84(4): 463-467.
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Acupuncture in the Treatment of Postoperative Nausea and Vomiting: A Report of One Case and Review of Related Literature

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