针灸强刺激疗法联合盐酸消旋山莨菪碱注射液治疗泌尿系结石性肾绞痛的镇痛效果研究

Research on analgesic effect of acupuncture and moxibustion strong stimulation therapy combined with raceanisodamine hydrochloride injection in the treatment of urinary calculi renal colic

关键词:  针灸疗法  针刺  镇痛  泌尿系结石  肾绞痛

Key words:  acupuncture and moxibustion therapy  acupuncture  analgesia  urinary calculi  renal colic

摘要:

[目的] 探究针灸强刺激疗法联合盐酸消旋山莨菪碱注射液治疗泌尿系结石性肾绞痛的镇痛效果及对血清总抗氧化能力（TAC）、缺血修饰清蛋白（IMA）、肌红蛋白（MYO）水平的影响。[方法] 纳入2023年8月—2024年9月石家庄市中医院收治的80例泌尿系结石性肾绞痛患者，均接受常规排石治疗。按简单化随机法将患者分为常规组（盐酸消旋山莨菪碱注射液治疗，40例）与针灸组（针灸强刺激疗法联合盐酸消旋山莨菪碱注射液治疗，40例）。对比2组患者镇痛效果（用药30 min后疼痛缓解率、疼痛发作频次、镇痛时间）、治疗前后疼痛评分[疼痛数字评价、Wong-Baker面部表情量表、简化McGill疼痛问卷（SF-MPQ）]、血清疼痛应激因子[P物质、前列腺素E₂（PGE₂）]及TAC、IMA、MYO水平，统计不良反应发生率。[结果] 针灸组用药30 min后疼痛缓解率与镇痛时间均显著高于常规组（P<0.05或P<0.01），疼痛发作频次显著低于常规组（P<0.05）；治疗后，两组NRS、Wong-Baker面部表情量表、SF-MPQ以及血清P物质、PGE₂、IMA、MYO水平均显著下降（P<0.05），且针灸组均显著低于常规组（P<0.05或P<0.01）；治疗后，两组TAC水平均显著上升（P<0.05），且针灸组均显著高于常规组（P<0.05）；针灸组不良反应发生率（12.50%）与常规组不良反应发生率（7.50%）差异无统计学意义（P＞0.05）。[结论] 针灸强刺激疗法联合盐酸消旋山莨菪碱注射液治疗泌尿系结石性肾绞痛的镇痛效果良好，有效改善血清疼痛应激因子及氧化损伤因子水平，安全有效，值得应用。

Abstract:

[Objective] To explore the analgesic effect of acupuncture and moxibustion strong stimulation therapy combined with raceanisodamine hydrochloride injection in the treatment of urinary calculi renal colic and its influence on serum total antioxidant capacity（TAC），ischemia modified albumin（IMA） and myoglobin（MYO） levels. [Methods] From August 2023 to September 2024， 80 patients with urinary calculi renal colic in Shijiazhuang Hospital of Traditional Chinese Medicine were included and received routine stone removal. According to the simplified random method，the patients were divided into conventional group（raceanisodamine hydrochloride injection treatment，40 cases） and acupuncture and moxibustion group（acupuncture and moxibustion strong stimulation therapy combined with raceanisodamine hydrochloride injection treatment，40 cases）. The analgesic effect（pain relief rate and pain attack frequency after 30 min of medication，analgesic time），pain scores [numerical rating scale（NRS），Wong-Baker facial expression scale，simplified McGill pain questionnaire（SF-MPQ）] and serum pain stress factors [substance P，prostaglandin E₂（PGE₂）] and TAC，IMA and MYO before and after treatment were compared between groups，and the incidence rates of adverse reactions were counted. [Results] After 30 min of medication，the pain relief rate and analgesic time in acupuncture and moxibustion group were significantly higher or longer than those in conventional group（P<0.05 or P<0.01），and the pain attack frequency was significantly less than that in conventional group（P<0.05）. After treatment，the scores of of NRS，Wong-Baker facial expression scale and SF-MPQ and levels of serum substance P，PGE₂，IMA and MYO in the two groups were significantly decreased（P<0.05），and the above scores and levels were significantly lower in acupuncture and moxibustion group than those in conventional group（P<0.05 or P<0.01）. After treatment，the level of TAC was significantly increased in both groups（P<0.05），and the level in acupuncture and moxibustion group was significantly higher than that in conventional group（P<0.05）. There was no significant difference in the incidence of adverse reactions between acupuncture and moxibustion group（12.50%） and conventional group（7.50%，P>0.05）. [Conclusion] Acupuncture and moxibustion strong stimulation therapy combined with raceanisodamine hydrochloride injection has a good analgesic effect in the treatment of urinary calculi renal colic，and it can effectively improve the levels of serum pain stress factors and oxidative injury factors，and it is safe and effective.