脐针“山泽通气”疗法对急性肾绞痛内源性致痛因子影响的研究  

Study on the Effects of Umbilical Acupuncture“Mountain and Lake Qi Circulation”Therapy on Endogenous Pain Factors in Acute Renal Colic

作　　者：李军军 吴文思 王贺 刘乔保 LI Junjun;WU Wensi;WANG He;LIU Qiaobao(Fujian University of Traditional Chinese Medicine Affiliated Third People's HospitalEmergency Department,Fuzhou 351008,China)

机构地区：[1]福建中医药大学附属第三人民医院急诊科,福建福州351008

出　　处：《中华灾害救援医学》2024年第9期1006-1009,共4页Chinese Journal of Disaster Medicine

基　　金：福建省卫健委科技计划项目(2020GGA069)。

摘　　要：目的从脐针治疗前后的内源性致痛因子含量变化,探索脐针治疗肾绞痛的效果和机制。方法收集2021年1月至2022年12月在福建中医药大学附属第三人民医院急诊科及门诊就诊的150例急性肾绞痛患者,根据随机数字表法分为观察组(采用脐针“山泽通气”法治疗)和对照组(采用地佐辛肌内注射),每组各75例。比较两组患者疼痛量表、血清致痛因子和镇痛因子水平及临床疗效。结果两组患者治疗前视觉模拟评分法(Visual Analogue Scale,VAS)评分和现时疼痛强度(Present Pain Intensity,PPI)评分均无显著差异(P>0.05)。治疗后,VAS评分和PPI评分均显著降低(P<0.001),且和对照组相比,观察组评分下降更显著(P<0.001)。治疗前,两组患者血清致痛因子P物质、5-羟色胺、镇痛因子β-内啡肽水平无显著差异(P>0.05);治疗后,观察组患者血清致痛因子P物质和5-羟色胺水平均显著升高(P<0.001),镇痛因子β-内啡肽水平显著降低(P<0.001);且和对照组相比,观察组血清P物质和5-羟色胺升高更显著,β-内啡肽下降更明显(P<0.001)。观察组临床有效率为94.67%,显著高于对照组的80.00%(P=0.007)。结论脐针“山泽通气”法治疗急性肾绞痛可明显降低患者疼痛感、降低内源性致痛因子水平,临床疗效显著。Objective To explore the efficacy and mechanisms of umbilical acupuncture in treating renal colic by examining changes in endogenous pain-inducing factors before and after treatment.Methods A total of 150 patients with acute renal colic,who visited the emergency and outpatient departments of our hospital between January 2021 and December 2022,were included in the study.Patients were randomly divided into an observation group(treated with the“Shanze Tongqi”umbilical acupuncture method,n=75)and a control group(treated with intramuscular dezocine,n=75).Pain scales,serum levels of pain-inducing and analgesic factors,and clinical efficacy were compared between the two groups.Results Before treatment,there were no significant differences in VAS or PPI scores between the two groups(P>0.05).After treatment,both VAS and PPI scores significantly decreased(P<0.001),with the observation group showing a more pronounced reduction compared to the control group(P<0.001).Before treatment,serum levels of substance P,serotonin,andβ-endorphin showed no significant differences between the two groups(P>0.05).After treatment,the levels of pain-inducing factors,substance P and serotonin were significantly elevated in the observation group(P<0.001),while the level of the analgesic factorβ-endorphin was significantly reduced(P<0.001).Compared to the control group,the observation group exhibited more substantial increases in substance P and serotonin,along with a more pronounced decrease inβ-endorphin(P<0.001).The clinical efficacy rate in the observation group was 94.67%,significantly higher than 80.00%in the control group(P=0.007).Conclusion The“Shanze Tongqi”umbilical acupuncture method significantly reduces pain and decreases endogenous pain-inducing factor levels in patients with acute renal colic,demonstrating notable clinical efficacy.

关 键 词：肾疾病 疼痛 Β-内啡肽 镇痛药 阿片类 

分 类 号：R256.5[医药卫生—中医内科学]