Beltaief Kaouthar, Grissa Mohamed Habib, Msolli Mohamed Amine, Bzeouich Nasri, Fredj Nizar, Sakma Adel, Boubaker Hamdi, Bouida Wahid, Boukef Riadh, Nouira Semir
Emergency Department, Fattouma Bourguiba University Hospital.
Research Laboratory LR12SP18, University of Monastir, Monastir.
J Pain Res. 2018 Feb 13;11:335-341. doi: 10.2147/JPR.S136299. eCollection 2018.
The objective of this study was to compare the analgesic effect and tolerance profile of acupuncture versus intravenous (IV) titrated morphine in patients presenting to the emergency department (ED) with renal colic.
A total of 115 patients were randomized into two groups. Patients in the IV titrated-morphine group (n=61) received 0.1 mg/kg morphine every 5 minutes until pain score dropped by at least 50% of its baseline value. Patients in the acupuncture group (n=54) received an acupuncture session of 30 minutes following a prespecified protocol. The visual analog scale (VAS) was used to assess pain intensity at baseline and at 10, 20, 30, 45, and 60 minutes following the start of the treatment protocol. Possible treatment side effects were also recorded.
No significant differences were found between the two groups concerning age, sex, or baseline VAS score. From the 10th minute until the end of the intervention, acupuncture was associated with a deeper analgesic effect than titrated morphine (<0.05 from the 10th minute and over). Analgesia was also faster in the acupuncture group, with time to obtain 50% reduction of baseline VAS of 14 minutes in the acupuncture group versus 28 minutes in the IV titrated-morphine group (<0.001). Only three patients in the acupuncture group experienced minor side effects versus 42 in the morphine group (<0.001). No major side effects were observed in this study.
In ED patients with renal colic, acupuncture was associated with a much faster and deeper analgesic effect and a better tolerance profile in comparison with titrated IV morphine.
本研究旨在比较针刺疗法与静脉滴定吗啡对因肾绞痛就诊于急诊科（ED）患者的镇痛效果及耐受性。
总共115例患者被随机分为两组。静脉滴定吗啡组（n = 61）的患者每5分钟接受0.1mg/kg吗啡，直至疼痛评分下降至少其基线值的50%。针刺组（n = 54）的患者按照预先指定的方案接受30分钟的针刺治疗。采用视觉模拟量表（VAS）在基线以及治疗方案开始后的10、20、30、45和60分钟评估疼痛强度。还记录了可能的治疗副作用。
两组在年龄、性别或基线VAS评分方面未发现显著差异。从第10分钟到干预结束，针刺疗法比滴定吗啡具有更深的镇痛效果（从第10分钟及以后P<0.05）。针刺组的镇痛起效也更快，针刺组获得基线VAS降低50%的时间为14分钟，而静脉滴定吗啡组为28分钟（P<0.001）。针刺组仅有3例患者出现轻微副作用，而吗啡组有42例（P<0.001）。本研究未观察到严重副作用。
在因肾绞痛就诊于急诊科的患者中，与滴定静脉注射吗啡相比，针刺疗法具有更快、更深的镇痛效果以及更好的耐受性。
