Pain Acupoints Along Meridians Acupuncture Analgesia Clinical Observation

1 Research objectiveTo remove worries of patients that puncturing at local points will lead to existent symptoms such as hypersusceptibility of pain and increased pain caused by touch more severe as well as medical inoculation,and to increase the compliance of patients during the acupuncture treatment by selecting Primary-Yuan points,Connecting-Luo points and Clefting-Xi points along meridians which cancer pain was affiliated to.To provide the thought and methods on alleviating cancer pain by acupuncture and also to observe the relationship between changes of grading of alleviating pain and the improvement of QOL of patients through observations on clinical effects of acupuncture treatment with distant points along meridians.2 Research methodsThe randomized control method was used in the research.Based on the regular treatment of western medicine,acupuncture treatment was applied by selecting Primary-Yuan points, Connecting-Luo points and Clefting-Xi points along meridians which cancer pain was affiliated to.After that effects were observed and compared with those in local point group and medicine group.2.1 RandomStratified Blocked Randomization was used in the research.The degree of cancer pain was taken as stratified factor.Patients were divided into mild,moderate and severe layers first. Then in each layer,patients were randomly divided into three groups:33 cases in distant point group,31 cases in local point group and 31 in medicine group.2.2 ControlThe distant point group was the treatment group and the other two groups were control groups. 2.3 Treatment methodThe distant point group based on the regular treatment of western medicine(not including pain management)chose Primary-Yuan point,Connecting-Luo points and Clefting-Xi points along meridians selected by different viscera where pain was affiliated to.The basic technique was needling vertically,reinforcing with reducing therapy at the same time,retaining needle 30 minutes,and manipulating it every ten minutes;Local point group also based on the regular treatment of western medicine(not including pain management)chose local points where pain located(if the pain area was large,the most painful spots were selected) in acupuncture.And the manipulation was the same as the treatment group;Medicine group used oral administration according to WHO Three Step Administration Principle.(Patients with mild pain took aspirin,25 to 100mg each time,4 to 6 hours as dosing interval.Patients with moderate pain took tramadol,50 to 100mg each time,4 to 6 hours as dosing interval.Patients with severe pain took morphine,10 to 30mg each time,with dosing interval 12 hours).Duration of treatment:According to the actual situation,7 days when the chemotherapy was concentrated was chosen as duration of treatment.2.4 Effective index observedCancer pain(graded by VAS),onset time for analgesia,duration for analgesia,safety and QOL etc.were graded and compared among different groups.Effect of analgesia was analyzed with quality of pain,meridians where pain was affiliated to.The relationship between remission extent of pain and the amelioration of QOL.2.5 Statistic analysisMeasurement data among groups were compared with mean comparison;Non-normal distribution was analyzed with Kruskal-Wallis test;Enumeration data were compared with the X~2 test;Correlation between two variables was analyzed with linear correlation.3 Research Results3.1 Comparison of baseline among groupsComparison was taken among groups from gender,mean number of age,distribution of age,duration of cancer pain,VAS before pain management as well as QOL score etc. According to X~2 test and variance analysis,three groups had no marked significances in comparison of all the index above(P＞0.05).The baseline was comparable.3.2 Comparison of total analgesic effect among groupsThere was no significant difference among distant point group,local point group and medicine group(P＞0.05).3.3 Comparison of VAS scores among groups after pain managementThere was no significant difference among different groups after rank sum test(P＞0.05).3.4 Comparison of onset time of analgesic effect among groups(minute)The onset time of analgesic effect of distant point group,local point group and medicine group were 26.1+8.1,22.6+7.4and 49.9+10.1 respectively.The onset time of analgesic effect of distant point group and local point group was significantly superior to that in the medicine group(P＜0.01).The onset time of analgesic effect of distant point group was a little bit longer than that of local point group,but with no significant difference(P＞0.05).3.5 Comparison of duration of analgesic effect for one time among groups(hour)The time of analgesic effect lasting in distant point group,local point group and medicine group was 4.9±1.7,4.3±1.6 and 5.5±1.9 respectively.The duration analgesic effect in medicine group was longer than that in distant point group and local point group.The difference between distant point group and medicine group was not significant(P＞0.05). There was a significant difference between local point group and medicine group(P＜0.05).3.6 The safety evaluation among different groupsThe results showed that distant point group and local point group could avoid toxic and side effects of medicine.The rates in distant point group and local point group were significantly superior to that in medicine group(P＜0.01).3.7 Comparison of QOL scores among groupsQOL scores in distant point group,local point group and medicine group were 48.3±4.8,46.3±6.4 and 42.3±5.1 respectively.The score of distant point group and local point group were significantly superior to that in medicine group(P＜0.01).3.8 The relationship between changes of grading of pain alleviating and improvement of QOL of patientsIt showed a positive relationship between changes of grading of pain alleviating and the improvement of QOL of patients.The interrelated index was 0.477.3.9 The relationship between analgesia effect of cancer pain and pain qualityAmong various pain qualities,the swollen pain,stabbed pain,numb pain,and sore pain shared the highest occurrence rate.The remission rates were 91.7%,96%,85%and 93.3% respectively.The differences among amelioration of four pain qualities were not significant by X~2 test(P＞0.05).3.10 The relationship between analgesia effect of cancer pain and meridians where pain was affiliated toThe analgesia effect was different according to divergent pain locations in yin and yang meridians.The effective rate was 96.2%if pain appeared in yang meridians,93.3%in yin meridians,83.3%in both yin and yang meridians.Compared with former ones,the difference was very significant(P＜0.01).4 Research ConclusionsThe analgesic effect of distant point group was proximate with that of local point group and medicine group but with short effect onset time and longer analgesic effective duration without any adverse effect and addiction of analgesics.This method is worthy to be applied in clinic.