World Journal of Acupuncture-Moxibustion (WJAM)
Vol. 25, No.1, 30th Mar. 2015·59·Clinical Report*BAI Yan ()1, CHEN Su-ning ()2, CHEN Li-rong ()1, WANG Bo ()1, 3

1. Third Affiliated Hospital of Liaoning University of TCM, Shenyang 110003, Liaoning Province, China;
2. Shengjing Hospital of China Medical University; 3. Liaoning University of TCM, Shenyang 110032,
Liaoning Province, China

First author: BAI Yan (1962-), female,associate chief physician.
Research field: anorectal clinic of TCM.

Objective To explore the effectiveness of treating postoperative pain of
mixed hemorrhoid by embedding needles in Èrbái (EX-UE 2) and findpossible ways for relieving postoperative pain of mixed hemorrhoids. Methods

Corresponding author: WANG Bo(1982-), male, attending physician.
Research field: integrated Chinese andwestern medicines.
E-mail: hanhankp@163.com*supported by General scientific projectfor institutions of higher learning in
Liaoning Province: L 2014370
Accepted on August 29,2014.

postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments.
Results
Complete remission of clinical pain was observed in 34 cases, accounting for50.00%; significantly effective in 19 cases, accounting for 27.94%; effective
in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating
postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2
is effectively satisfactory.
KEY WORDS: Èrbái (EX-UE 2); postoperative pain of mixed hemorrhoids;
press needle; acupoint needle-embedding

Postoperative pain of mixed hemorrhoids directlydiscourages patients from being operated on, which
has been one of common and tough clinical problems.
It even becomes one of the main concerns among
patients with anorectal diseases that are afraid toseek medical treatment [1]. Currently, postoperative
analgesia methods for anorectal disease are multiply,
such as topical application of long-acting analgesics,
application of patient-controlled analgesia (PCA), oral
administration of analgesic drugs, etc., and evaluation
on whether they may bring negative impacts on thehealing of wounds after surgery are not available.
Acupuncture has been widely applied clinically for
its rapid effect, economy, convenience and no adverse
reactions. The authors treated postoperative pain of
mixed hemorrhoid by embedding press needle in Èrb i(EX-UE 2). Here’s the report.

CLINICAL DATA
General Information
All the 68 patients were recruited from inpatient
department of Liaoning Coloproctological Hospitalfrom July 2013 to December 2013. They were rstly
diagnosed with mixed hemorrhoids and accepted
milligant-morgant hemorrhoidectomy, and thosewith anal fissure and anal papilla tumor detectedby digital rectal examination (DRE) and anoscopewere excluded. Thirty-six cases were male and32 cases were female, aged 18 to 60, with the averageof 32.2 ± 10.1 years old, and the course of disease of
0.4 to 6 years.

Diagnostic criteria
The included cases were in conformity with

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criteria of mixed hemorrhoids specified in Anorectal
Epidemiology Treated with Integrated Chineseand Western Medicines (China Press of Traditional
Chinese Medicine, 2009) [2], and aged 18 to 60 years
old; they could respond properly with clear mind,
sign the Informed Consents Form and cooperate withthe physician on completion of visual analogue scale(VAS) with the rating 4; and they were not operated
on within half a year.

METHODS
Before the surgery, a routine examination wasconducted; during the surgery, caudal anesthesia wasfollowed by milligant-morgant hemorrhoidectomy.
After the surgery, the Chinese medicine was applied
over the wound surface. Four hours after the surgery,the therapy by embedding needles was conducted.
Acupoints selection: bilateral EX-UE 2 (Figure 1
is the speci c locations).

World Journal of Acupuncture-Moxibustion (WJAM)
Vol. 25, No.1, 30th Mar. 2015

marked on one end for no pain and “10” marked on
the other end for sharp pain; the rest indicated various
degrees of pain. The patient was asked to mark on theline in line with how painful he or she felt. The rating
was determined. The percentage of change in pain wasobserved by means of weighted value of VAS, andclinical effect was analyzed according to the changesin pain. A was set for VAS score before treatment andB for VAS score after treatment, and VAS weightedvalue = (A-B)/A× 100%.

Evaluation criteria
Efficacy criteria: VAS weighted value = (A-B)/
A ×100%, clinical cure and complete remission ofpain, weighted value 75%; significantly effective
and apparent remission of pain, 50% weightedvalues<75%; effective and partial remission of pain,
25% weighted values <50%; ineffective and noremission of pain, weighted values <25%.

RESULTSA m on g t h e 6 8 pat i e n t s , 34 w er e c u re d ,accounting for 50.00%; 19 were signi cantly effective,accounting for 27.94%; 13 were effective, accountingfor 19.12%; 2 were ineffective, accounting for 2.94%.
The total effective rate was 97.06%.
The VAS score of the postoperative pain of mixed
hemorrhoid patients with different ef cacy is shown intable 1.

Manipulation: the patient was asked in lateralposition, and the skin was pierced by press needles(SEIRIN pyonexes, 0.20 mm×1.5 mm), which were
fixed by breathable tape and gently pressed for 5 to
10 min to the extent that the patient felt sore. The
patient was asked to press the needles for one time
every two hours and half an hour prior to medication
after surgery. The pyonexes were pulled out after
being retained for 24 h. Without any interval, the press
needles were applied in the same way as describedabove with 7 days as a course of treatment. Theef cacy was elevated after one course of treatment.

Patients Before treatment

After treatment34

6.2±3.6

3.3±4.32)19

6.1±2.6

3.2±3.32)

Effective

13

5.3±3.2

4.8±3.81)

Ineffective2

5.1±2.6

Cured

Notes: compared with that before treatment,

4.7±2.81)2)

P<0.05; P<0.01.

The change of VAS score of the 68 postoperative
pain of mixed hemorrhoid patients in different time
points is shown in table 2.

Observation indics
In accordance with the diagnostic criteria of pain
proposed by the Seventh National Coloproctological
Conference in 1992, visual analog scale (VAS) values
were evaluated at varying points of time before andafter treatment. VAS was applied in the way: a lineof 10 cm was drawn on a sheet of paper, and “0” wasTime (d)035VAS (score, x±s, n=68)

7.3±4.36.2±3.3

5.8±3.81)71)

4.2±2.82)

2)

Notes: compared with that before treatment, P<0.05; P<0.01.

It is shown in table 2 that the pain has decreased
as time goes by.

World Journal of Acupuncture-Moxibustion (WJAM)
Vol. 25, No.1, 30th Mar. 2015

EXPERIENCES
Postoperative pain is one of the common surgicalcomplications, closely related to the disease, thesurgical site and the wound. Recovery and normal lifeof patients may be impacted by milligant-morgant
hemorrhoidectomy that causes sharp and prolonged
postoperative pain resulting from anatomical factors,
bowel irritation and stimulation during medication.
In r ecent years, stud ies on postoperative
analgesia of anal diseases have multiplied. Preemptive
analgesia and patient-controlled analgesia (PCA) in
postoperative pain have been widely applied. PCA is
the most effective in analgesia. However, its indwelling
catheters and drugs are likely to cause a variety ofcomplications, which are hard to bear by patients. EXUE 2 is extra point. Though the clinical efficacy oftreating anorectal diseases by needling EX-UE 2 isbeyond doubt, the clinical application is rare. Needlingthe twelve meridians are widely applied, especiallythe bladder points or local points. It is inconvenient
to needle local points for the postoperative patientswith anorectal diseases, and secondary pain may be
induced [3]. EX-UE 2 is extra point, which originatesfrom the masterpiece of(, Bian Que
Miraculous Effective Classic of Acupuncture), which
said that anal stula can be treated with acupuncture,and tenesmus is the most troublesome; patients may
suffer from itching, pain or bleeding, and EX-UE 2
located on the forearm can be used. EX-UE 2 is in theupper limb and the manipulation is easy with goodeffect.

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tension relief after the surgery. Anatomical structurearound EX-UE 2 includes radial artery, veins andartery and vein interossea volaris; medial forearm
cutaneous nerve, nervus cutaneus antebrachii lateralis,
median nerves and radial nerves. Pyonex therapy
grows out of ancient Chinese acupuncture. It has been
well received by the patients in fear of acupuncture
or with chronic diseases due to its easy manipulation,
fast efficacy, less pain, wide application and easy
movement. SEIRIN pyonex developed by SEIRINCORPORATION is disposable, slender and easy tooperate [4].
The therapy of treating postoperative pain of
mixed hemorrhoid by embedding needles in EXUE 2 is easy, safe, economical and practical withgreat clinical application value. The authors intends
to further enhance the study so that the therapy ofChinese medicine will play a greater role in analgesia
of postoperative pain of anal diseases.

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[3]

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Lu JG, Ding YJ, Li GD. Anorectal epidemiology treatedwith integrated Chinese and Western medicines. Beijing:
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