| As the society progresses rapidly, work-related injuries, emergency accidents and natural disasters have led to a growing number of injuries, disabilities and/or amputations. In particular, phantom limb pain (PLP) as a main complication for patients with amputated limbs, has attracted extensive attention. Phantom limb pain (PLP), also known as fantasized limb pain, means that a patient can consciously feel the existence of an amputated limb and is troubled by difference degrees of pains which usually occur at the farthest ends of amputated limbs. In most cases, PLP co-exists with the pain of amputation and a fantasized, lingering sense as if the amputated limbs still existed. Patients suffering from PLP experience a deterioration in quality of lives, a decrease or even a complete loss of working capacity and a decrease of social capabilities, etc. Some patients are troubled by PLP for different periods of time ranging from a few years to a few dozen years; hence their treatment and rehabilitation are seriously compromised and their post-trauma quality of life tends to worsen. Such patients would find it difficult to function properly in society or in their work positions. Therefore, PLP has become an urgent issue to resolve in the recovery and rehabilitation process for patients with amputated limbs. Today, main treatment methods for PLP include medication, physical therapy, surgery, psychological intervention, TCM treatment, etc., among which the best efficacy results have been achieved by using a combination of ear acupuncture and rehabilitation approaches. In western medicine, surgeries and pain-killer medicine are used frequently, with good but temporary pain alleviation effects and certain side effects, and symptoms recur from time to time despite such intervention which has limitations in clinical applications. Therefore, PLP is chosen as the main research topic of this paper.ObjectiveUnder the guidance of TCM theories, this paper intends to provide an observation on treatment effects of using a combination of ear acupuncture and rehabilitation approaches, explore more effective methods for treating PLP, help alleviate the sufferings of PLP patients and improve their quality of life.Methods60 amputated patients hospitalized between 2012 and 2014 and suffering from PLP symptoms for 3-5 days have been chosen as the subject of this research and have been observed for more than 10 days after their respective surgery. These 60 cases are divided into the experiment group and control group, with each group comprising 30 cases. All patients in each group have evident PLP symptoms, including a sense of being itchy (as if ants were moving all over their body), icy-cold, painful as if being prodded by needles, scorchingly hot, etc., and a few patients sweated profusely or were too sensitive on the side of his or her body where the amputation was done. Experiment group:ear acupuncture plus rehabilitation therapy. Acupuncture needles were applied to ear acu-points Shenmen (literally Gate of God) and Subcortex as well as painful points caused by amputation (fingers, wrists, elbows, knees, ankles, etc. depending on each patient’s amputated limbs). Needles were inserted into the skin at a 90-degree angle and a depth of 0.1cm~0.3cm so as to reach subcutaneous tissues or the surface of cartilage, with a clear sense of feeling heavy and bulgy in the acu-points. The treatment session lasted 30 minutes and needles were turned every 10 minutes; disinfecting cotton swabs were used to stop the bleeding when needled were pulled out. One treatment session daily was provided to each patient, combing ear acupuncture and rehabilitation therapy Control group:rehabilitation therapies include TENS therapy, mirror therapy, psychological intervention, wax therapy and massage. One treatment per day was administered, but with no ear acupuncture. Both groups were provided with 3 rounds of treatment, with each round lasting 12 days. Efforts were made to observe the treatment effects of each group. Observation and measurement indicators:A simplified version of the McGill questionnaire on pains (SF-MPQ) was prepared according to levels of pain felt by patients before the therapy administered through this research,30 minutes after treatment,1 week,3 weeks and 5 weeks post treatment. Also, the Hamilton Anxiety Scale (HAMA) was measured before and after the conclusion of treatment.ResultsSPSS17.0 software has been used to perform comparison tests (t) based on results before and after treatment of randomly chosen cases.1. Out of the experiment group of 30 patients,8 have been cured (26.66%), with total efficacy of 76.67%, whereas 2 of the 30 patients of the control group have been cured (6.66%), with total efficacy of 56.67%. Significant difference (P<0.01) has been observed between these two groups, with the experiment group doing better than control group.2. Better treatment efficacy has been observed for patients with low-and medium-levels of pain while the efficacy for patients with severe symptoms has been poorer. Significant difference (P<0.01) has been observed between these two groups, with the experiment group generating better treatment results than the control group.3. There has been no meaningful difference in the SF-MPQ score of these two groups before treatment was done (P>0.05). However, there has been a clear difference post treatment, when comparing PRI and PPI of the two groups (P<0.01) and VAS (P<0.05), and it has been therefore concluded that treatment effects of the experiment have been better than those of the control group.4. Anxiety levels decreases for both groups, but the experiment performed better than the control group.ConclusionA combination of ear acupuncture and rehabilitation therapy has clearly yielded much better treatment results than pure rehabilitation. In particular, when treating early stages of pain, early intervention by applying ear acupuncture has clearly helped patients experience a decreases pain level and a better and more effective rehabilitation and treatment process, thus generating better treatment results. Through such combined therapy, symptoms have been significantly alleviated and further progress in PLP has been effectively curbed, with a reduction in pain levels; thus the experiment group has had much better treatment results than the control group. At the same time, ear acupuncture is a simple and easy-to-administer procedure, with clear therapeutic effects and no toxical or side effects, and is therefore a safe and effective treatment method that is worth being widely applied clinically and being researched further. |
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