早期针刺干预对急诊科疑似尿路结石所致急性肾绞痛患者的止痛效果:一项随机临床试验

Early acupuncture intervention for pain relief in emergency department patients with suspected acute renal colic caused by urinary calculi: a randomized clinical trial.

作者信息

Cao Ying, Qu Zhicheng, Zhang Shuwen, Liu Yunhua, Jia Liancheng, Pei Xiaolu, Wang Xiao, Zhang Dantong, Li Binyan, Lu Haitian, Ding Maoyu, Bai Yinglu, Wang Shuang, Yang Yufei, Hu Jing, Peng Wei, Guo Wei, Xu Xiaolong, Liu Qingquan

机构信息

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

Emergency and Critical Care Centre, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

出版信息

QJM. 2025 May 1;118(5):329-336. doi: 10.1093/qjmed/hcaf011.

Abstract

BACKGROUND

Renal colic is one of the worst types of pain in acute renal colic caused by urinary calculi (ARCUC). We previously proved that acupuncture can alleviate the pain in ARCUC patients, but its effect on suspected ARCUC remains unclear.

OBJECTIVE

The objective was to evaluate the effectiveness and safety of acupuncture in patients with suspected ARCUC.

AIM

This prospective, double-blind, sham acupuncture-controlled, randomized clinical trial was conducted from July 2021 to June 2024 in an emergency department in China.

METHODS

The patients immediately received acupuncture treatment or sham acupuncture treatment after randomization. The primary outcome was the response rate at 10 minutes (pain relief rate) after needle manipulation. The secondary outcomes included the response rates at 0, 5, 15, 20 and 30 minutes, trends in the numerical rating scale score over time, patient satisfaction, the analgesic injection rate at 30 minutes, the surgical intervention rate, the revisit rate and the occurrence of adverse events.

RESULTS

This trial enrolled 84 participants with suspected ARCUC patients, who immediately received acupuncture treatment or sham treatment after randomization. The pain response rates at 10 minutes were 64.3% and 16.7% in the acupuncture group and sham group, respectively, and the difference between the groups was 47.6% (95% CI, 29.3-66%; P < 0.01). The response rates of acupuncture were also significantly higher than those of sham acupuncture at 0, 5, 15, 20 and 30 minutes.

CONCLUSIONS

These results suggest that acupuncture could alleviate the pain in patients with suspected ARCUC safely.

TRIAL REGISTRATION

Chinese Clinical Trial Registry: ChiCTR2100049069.

摘要

背景

肾绞痛是由尿路结石引起的急性肾绞痛(ARCUC)中最严重的疼痛类型之一。我们之前证明了针刺可以缓解ARCUC患者的疼痛,但其对疑似ARCUC的效果仍不清楚。

目的

评估针刺治疗疑似ARCUC患者的有效性和安全性。

目的

本前瞻性、双盲、假针刺对照、随机临床试验于2021年7月至2024年6月在中国的一家急诊科进行。

方法

患者随机分组后立即接受针刺治疗或假针刺治疗。主要结局是针刺操作后10分钟的反应率(疼痛缓解率)。次要结局包括0、5、15、20和30分钟时的反应率、数字评分量表评分随时间的变化趋势、患者满意度、30分钟时的镇痛注射率、手术干预率、复诊率和不良事件的发生情况。

结果

本试验纳入了84例疑似ARCUC患者,随机分组后立即接受针刺治疗或假治疗。针刺组和假针刺组10分钟时的疼痛反应率分别为64.3%和16.7%,两组间差异为47.6%(95%CI,29.3 - 66%;P < 0.01)。在0、5、15、20和30分钟时,针刺的反应率也显著高于假针刺。

结论

这些结果表明针刺可以安全地缓解疑似ARCUC患者的疼痛。

试验注册

中国临床试验注册中心:ChiCTR2100049069。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e43e/12341676/82360c2bdbf8/hcaf011f1.jpg

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