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研究生:李詔信
研究生(外文):Chao-Hsin Lee
論文名稱:經皮神經電刺激對柯雷氏骨折術後疼痛療效之評估:隨機、雙盲、控制的研究
論文名稱(外文):The effect of transcutaneous electric nerve stimulation (TENS) on post-operative pain in patients with Colles’ fracture: randomized, double blinded controlled study
指導教授:羅婉瑜羅婉瑜引用關係
學位類別:碩士
校院名稱:中國醫藥大學
系所名稱:中西醫結合研究所碩士班
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:48
中文關鍵詞:經皮神經電刺激柯雷氏骨折Visual analogue scale
外文關鍵詞:Transcutaneous nerve electric stimulation (TENS)Colles’ fracturevisual analogue scale (VAS)
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背景與目的:柯雷氏骨折常因跌倒、運動傷害及車禍而發生,尤其在骨質疏鬆的老人及停經的婦女更是常見。因此本研究的目的是評估經皮神經電刺激(TENS)對柯雷氏骨折病人術後疼痛的療效。
材料與方法:將36位合乎納入標準的柯雷氏骨折病人術後隨機分成兩組,每組18人如下:(1)實驗組,術後接受TENS治療,每日20分鐘,連續5日;(2)對照組,方法與實驗組相同,但施行假TENS治療。主要評估是根據Visual Analogue Scale(VAS),次要評估是根據pain control analgesia(PCA)和NSAID使用的總劑量以及嘔吐發生次數。
結果:實驗組於術後第一天到第五天TENS電刺激後的VAS減少都比對照組大,但實驗組從術後第二天到第五天的TENS電刺激前的VAS與對照組相似;TENS不能減少PCA、 NSAID使用的總劑量和嘔吐的次數。
結論:經皮神經電刺激能緩解柯雷氏骨折病人的術後疼痛,但這種止痛效果是短暫,因此推論可應用於臨床需要短暫止痛的病人。


Background and Purpose: The most etiology of Colles’ fracture is resulting from old age associated with osteoporosis and falling down on the ground. They are poor tolerance to the non-steroid anti-inflammatory drug (NSAID) in old aged patients, and that easily results in occurrence of gastric ulcer even perforation. There is an important topic how to decrease to dose of NSAID in post-operative patient. Many studies report that transcutaneous electric nerve stimulation (TENS) has analgesic effect. Therefore, the aim of the present study was to assess the analgesic effect of TENS on post-operative pain in patients with Colles’ fracture.
Materials and Methods: The present study was a randomized, double blinded controlled clinical trial. A total of 36 patients with Colles’ fracture, and all of them qualified the inclusion criteria and were divided randomly into two groups of 18 patients as follows: 1) experimental group, received TENS treatment continuous 5 days, 20 min in duration every day; control group, the methods were identical the experimental group, but received sham TENS treatment (without electric stimulation). Primary measure was according the visual analogue scale (VAS), and secondary measure was according to the counts of pain control analgesia (PCA), nausea, and the dose of NSAID.
Results: The decrease of VAS was greater in the experiment group than that in control group from first to 5th days after operation, whereas the VAS was similar between 2nd to 5th days prior to the TENS after operation. The counts of PCA, nausea and the dose of NSAID were not significant difference between experiment and control groups.
Conclusion: TENS may transient relief the post-operative pain in patients with Colles’ fracture, suggesting TENS may use in the patient who need short-term analgesia.


目 錄
謝辭
中文摘要
標題目錄
圖目表
表目表
第一章 前言 1
第一節研究背景 1
第二節研究動機與目的 2
第二章 文獻探討 3
第三章材料與方法 14
第一節研究對象 14
第二節治療方法 16
第三節評估與參數收集 19
第四節樣本數估算 21
第五節試驗流程 22
第六節皮神經電刺激的安全評估 23
第七節 統計方法 24
第四章 結果 25
第五章 討論 31
參考文獻 34
英文摘要 46


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