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[肾结石体外冲击波碎石术中针刺镇痛——初步结果]

[Analgesia with acupuncture in extracorporeal shock wave lithotripsy of kidney stones--first results].

作者信息

Hodzic J, Golka K, Selinski S, Pourvali H, Sommerfeld H-J

机构信息

Klinik für Urologie und Kinderurologie, Marien-Hospital, 45768, Marl.

出版信息

Urologe A. 2007 Jul;46(7):740, 742-4, 746-7. doi: 10.1007/s00120-007-1362-1.

DOI:10.1007/s00120-007-1362-1
PMID:17619207
Abstract

INTRODUCTION

To date, extracorporeal shock wave lithotripsy (ESWL) has been successfully used with awake anaesthesia. The aim of this study was to investigate whether acupuncture at certain acupuncture points can lower or even substitute the demand for analgesics.

SUBJECTS AND METHODS

ESWL treatments were selected for the two groups using the registration number for randomisation. Both groups rated pain sensation prior to the ESWL treatment using a numeric pain scale. The subjects in the analgesic group received 50 mg pethidine and 10 mg diazepam whereas the subjects in the acupuncture group received acupuncture at the points colon 4 bilateral, liver 3 bilateral, urinary bladder 23 bilateral, gall bladder 25 contralateral to the stone, circulation 6 bilateral, and Ren Mai. Every minute till 21 min after starting the therapy and 10 min after termination, the pain sensation was rated. Analgesics were intravenously applied in all subjects reporting a pain sensation higher than 5. Additionally, the pain management was rated with a non-evaluated questionnaire.

RESULTS

In the present study on 102 patients, analgesia by acupuncture was successfully applied to patients who underwent ESWL. The analgesic effect of acupuncture was significantly superior to the analgesic effect of analgesics. In the group treated by acupuncture, 20 subjects received additionally analgesics. In general, these subjects presented bigger kidney stones and were younger. Subjects with left-sided kidney stones required more frequently analgesics. The results were not significant.

摘要

引言

迄今为止,体外冲击波碎石术(ESWL)已成功用于清醒麻醉。本研究的目的是调查针刺某些穴位是否可以降低甚至替代镇痛药物的需求。

对象与方法

使用注册号对两组进行ESWL治疗随机分组。两组在ESWL治疗前均使用数字疼痛量表对疼痛感觉进行评分。镇痛组的受试者接受50mg哌替啶和10mg地西泮,而针刺组的受试者针刺双侧大肠俞、双侧肝俞、双侧膀胱俞、结石对侧的双侧胆俞、双侧环跳和任脉。在治疗开始后直至21分钟以及治疗结束后10分钟,每分钟对疼痛感觉进行评分。所有报告疼痛感觉高于5分的受试者均静脉注射镇痛药物。此外,用一份未评估的问卷对疼痛管理进行评分。

结果

在本项针对102例患者的研究中,针刺镇痛成功应用于接受ESWL治疗的患者。针刺的镇痛效果明显优于镇痛药物的镇痛效果。在针刺治疗组中,20名受试者额外接受了镇痛药物治疗。总体而言,这些受试者的肾结石更大且更年轻。左侧肾结石患者更频繁地需要镇痛药物。结果无统计学意义。

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