| Objective:Acute renal colic is a common disease in the emergency department, the main manifestations of the waist abdomen ache due to urinary stones remove or obstruct in the renal pelvis or ureter. It has characteristics of rapid onset, severe pain, recurrent and so on, and associated with gastrointestinal discomfort. Acupuncture therapy is especially good for pains. This paper aims to give full play to the advantages of Chinese medicine acupuncture, combined with the Characteristic of "Qiu’s Point", investigate the clinical effects of Dragon-tiger fighting needling method on "Qiu’s point" in the treatment of renal colic. Through praxiology, kidney tissue biopsy, the expression of TXA2, PGI2 and 5-HT in the renal colic rats, seek for the treatment mechanism of Dragon-tiger fighting needling method on "Qiu’s point"Method:1. The Clinical ObservationThe acute renal colic patients that were diagnosed by emergency department of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine during the period from March 2013 to October 2015 were randomly divided into control group, electro-acupuncture(EA) group and "Qiu’s point" group. Each group consists of 20 patients. In the control group, patients were injected flurbiprofen axetil injection once. EA group patients were applied to electro-acupuncture in "Shenshu" (BL23), "Sanjiaoshu" (BL22), "Sanyinjiao" (SP6), "Shuiquan" (KI5). "Qiu’s point" group patients were treated with dragon-tiger fighting needling method. Recorded the VAS pain score after treatment 10 min,30 min,120 min, the onset time of the analgesic effect, the number of renal colic recurred patients within 24h, and truthfully recorded adverse reactions.2. The Experimental ResearchThe male SD rats were randomly divided into three groups:normal group, model group and "Qiu’s point" group. Model group and "Qiu’s point" group used 1% ethylene glycol and 1% ammonium chloride as lure stone agent to establish the renal colic model induced by calcium oxalate stone in 10 days. Model group rats without any treatment, "Qiu’s point" group rats treated with dragon-tiger fighting needling method for 3 days. Then observed the different groups of rats’praxiology, pain threshold value, spontaneous pain score, kidney tissue biopsy, TXA2, PGI2 and 5-HT expression in renal tissue.Results:1. The Clinical Observation①The comparison results of general information:A total of 60 patients, no case in the each group were dropped out during the test and all patients completed clinical observation. The statistical results of age, gender, related parameters of urine, pain sites, calculus location and the VAS pain score before treatment, the comparisons between the three groups were not statistically significant (P>0.05).② The comparison results of clinical efficacy:(1) Comparison of the VAS pain score after treatment 10min between th e EA group and control group were statistical significant (P<0.05), and also between the "Qiu’s point" group and control group.(2) Comparison of the VAS pain score after treatment 30,120min betwe en the 3 groups were not statistical significant (P>0.05).(3) The average onset time of the analgesic effect was 14.05±7.09min in control group,6.50±3.71min in EA group,6.74±4.83min in "Qiu’s p oint" group. The comparisons between the three groups were statistically significant (P<0.05).(4) The comparisons between number of renal colic recurred patients w ithin 24h in three groups were not statistical significant (P>0.05).③Adverse events recorded:all trial patients had no any adverse events.2. The Experimental Research①The comparison results of general information:(1) The comparisons of the weight, pain threshold value and spontaneo us pain score before modeling between three groups were not statistical s ignificant (P>0.05).(2) The comparisons of the weight, pain threshold value and spontaneo us pain score after modeling between model group and "Qiu’s point" grou p were not statistical significant (P>0.05), the normal group respective ly compared with other groups were statistical significant (P<0.05).②The comparison results of the experimental research:(1)The pain threshold value of "Qiu’s point" group were higher than model group, spontaneous pain score were lower than model group after th e first day of treatment, which were statistical significant (P<0.05).(2)The pain threshold value of "Qiu’s point" group were higher than model group, spontaneous pain score were lower than model group after th e second day of treatment, which were statistical significant (P<0.05). The comparisons of pain threshold value and spontaneous pain score betwee n control group and "Qiu’s point" group after the second day of treatme nt were not statistical significant (P>0.05).(3)The pain threshold value of "Qiu’s point" group were higher than model group, spontaneous pain score were lower than model group after th e third day of treatment, which were statistical significant (P<0.05). T he comparisons of pain threshold value and spontaneous pain score between control group and "Qiu’s point" group after the third day of treatment were not statistical significant (P>0.05).(4)The kidney weight of normal group respectively compared with other groups were statistical significant (P<0.05), other groups compared wit h each other were not statistical significant (P>0.05).(5)The comparisons of expression of TXA2, PGI2 and 5-HT between "Qiu’ s point" group and normal were statistical significant (P<0.05).(6)The comparison of ratio of TXA2/PGI2 between normal group and "Qi u’s point" were statistical significant (P<0.05), other groups compared with each other were not statistical significant (P>0.05).(7) Pathological results of the rats kidney in normal group showed that there were no deposition of calcium oxalate crystals, the shape of glomeruli were regular, no expansion of the renal tubular, cell structures were clear. Model group showed that the shapes of glomeruli were regular, the renal tubules were dilated and filled with calcium oxalate crystals, disordered arrangement of cell, epithelium were necrotic. "Qiu’s point" group showed that the shapes of glomeruli were regular, some of renal tubules were dilated and filled with calcium oxalate crystals, cell structures were clear, few of epithelium were necrotic.Conclusion:1. The Clinical ObservationThe analgesic effect of EA group and "Qiu’s point" group were better than control group after treatment 10min. The effects were similar after treatment 30min and 120min. The average onset time of the analgesic effect in EA group and "Qiu’s point" group were more shorter than control group. The numbers of renal colic recurred patients were similar between three groups. This study demonstrates that the EA group and "Qiu’s point" group can achieve rapid and lasting analgesic effect, have little complications. "Qiu’s point" group are more simple operation, utility and convenient, it is worth to be applied and extended in the emergency department.2. The Experimental Research"Qiu’s point" group could increase the pain threshold value and decrease the spontaneous pain score, the results were similar with normal group. The mechanism of analgesic effect may through inhibition of TXA2, PGI2 and 5-HT, infiltration of inflammatory cells, relieved the dilation of renal tubular and the pain cause by 5-HT. |
PDF Full Text Request