探讨“动留针术”治疗上尿路结石急性发作期的临床疗效
|
摘要
目的观察"动留针术"治疗上尿路结石急性发作期的临床疗效并探讨其作用机制。方法 50例患者采用"动留针术"治疗:常规针刺(阿是穴、腰夹脊、足三里)合"胸胁咳气法"引申法,观察治疗后疼痛评分、次症评分、总体评分改善情况,镇痛起效时间,镇痛疗效,总体疗效。结果治疗后疼痛评分、次症评分、总体评分与治疗前比较均明显下降(均P <0.05),且大多患者治疗完成安静状态下无明显疼痛,无或只有1个伴随症状。治疗30 min后,镇痛疗效总有效率96.00%;总体疗效总有效率98.00%。留针后镇痛起效时间为(4.06±2.81) min。随访期间,24 h内疼痛复发共7例,复发率14.00%。其中女性复发2例,男性复发5例,男女复发率差别不大(P> 0.05)。治疗中及治疗后均未见明显不良反应。结论 "动留针术"对上尿路结石急性发作期镇痛疗效显著,镇痛迅速,复发率低,无不良反应。
Objective: To observe the clinical effect of "Somatic movement Techniques during Needle Retention" in the treatment of acute episode of upper urinary tract calculi and to explore its mechanism. Methods: Fifty patients were treated with "Somatic movement Techniques during Needle Retention". Routine needling(Ashi points,Waist Jiaji,Zusanli) combined with "Chest-flank cough method" was used to observe the improvement of pain score,concomitant symptom score,overall score,the onset time of analgesia,analgesic effect and overall effect after treatment. Result: After treatment,the pain score,concomitant symptom score and overall score were significantly decreased compared with those before treatment(all P < 0.05). Most patients had no obvious pain and had no or only one accompanying symptom after treatment. After 30 minutes of treatment,the total effective rate of analgesia was 96.00%,and the total effective rate was 98.00%. The onset time of analgesia after needle retention was(4.06±2.81) min. During the follow-up period,pain recurred in 7 cases within 24 hours,with a recurrence rate of 14.00%. There were 2 female recurrences and 5 male recurrences,and the recurrence rate between men and women was not significantly different(P > 0.05). There were no obvious adverse reactions during and after treatment. Conclusion: "Somatic movement Techniques during Needle Retention " has a remarkable analgesic effect in acute episode of upper urinary tract calculi,with rapid analgesia,low recurrence rate and no adverse reactions.
Objective: To observe the clinical effect of "Somatic movement Techniques during Needle Retention" in the treatment of acute episode of upper urinary tract calculi and to explore its mechanism. Methods: Fifty patients were treated with "Somatic movement Techniques during Needle Retention". Routine needling(Ashi points,Waist Jiaji,Zusanli) combined with "Chest-flank cough method" was used to observe the improvement of pain score,concomitant symptom score,overall score,the onset time of analgesia,analgesic effect and overall effect after treatment. Result: After treatment,the pain score,concomitant symptom score and overall score were significantly decreased compared with those before treatment(all P < 0.05). Most patients had no obvious pain and had no or only one accompanying symptom after treatment. After 30 minutes of treatment,the total effective rate of analgesia was 96.00%,and the total effective rate was 98.00%. The onset time of analgesia after needle retention was(4.06±2.81) min. During the follow-up period,pain recurred in 7 cases within 24 hours,with a recurrence rate of 14.00%. There were 2 female recurrences and 5 male recurrences,and the recurrence rate between men and women was not significantly different(P > 0.05). There were no obvious adverse reactions during and after treatment. Conclusion: "Somatic movement Techniques during Needle Retention " has a remarkable analgesic effect in acute episode of upper urinary tract calculi,with rapid analgesia,low recurrence rate and no adverse reactions.
引文
[1]白培德,姜昊文,丁强.上尿路结石的诊断和治疗[J].上海医药,2014,35(6):3-6.
[2]史世鹏,刘春,黄小惠,等.泌尿系结石病因认识及综合预防[J].中国医学创新,2016,13(28):145-148.
[3]蒋伟芳.行气通腑合化瘀通淋法治疗尿路结石的临床疗效观察[J].中西医结合研究,2017,9(1):19-20,23.
[4]朱宇,陈能杰,朱红武.曲马多联合间苯三酚治疗肾绞痛53例临床观察[J].海峡药学,2008,20(11):78-79.
[5]江亮.浅述泌尿系结石的中医特效疗法[J].中国中医药现代远程教育,2010,8(23):167-169.
[6]梁会,袁国兴,蒋志平.快针并闪罐治疗泌尿系结石发作期疼痛疗效观察[J].中国中医急症,2015,24(3):497-498.
[7]宋小兵,赵剡,潘正启,等.吗啡分次注射联合间苯三酚治疗肾绞痛的疗效观察[J].临床急诊杂志,2011,12(3):147-148,150.
[8]王毅刚.动留针术的临床应用[J].南京中医学院学报,1992,44(4):110-111.
[9]王琴,黄小权,谢欣欣,等.关于疼痛患者的护理干预措施[J].实用临床护理学电子杂志,2018,3(51):194.
[10]陈敏,李赛美.电针郄募穴缓解肾绞痛及其伴随症状26例临床观察[J].中医杂志,2012,53(15):1308-1311.
[11]中华医学会.临床诊疗指南疼痛学分册巨[M].北京:人民卫生出版社,2007:19-21.
[12]毕军,陈玉中,朱成,等.疼痛评定与测量方法的研究[J].中国医疗器械信息,2017,23(2):6-8.
[13]李媛媛.古代中医石淋病史研究[D].北京:中国中医科学院,2010.
[14]谢云.华佗夹脊穴与临床应用[J].针灸临床杂志,2000,17(5):54-55.
[15]孙伊平,张娇娇,李婷,等.夹脊穴研究进展概述[J].长春中医药大学学报,2016,32(5):1092-1094.
[16]裴莹,赵雪,李忠正,等.钙离子与肥大细胞在针刺效应产生中作用的研究[J].临床和实验医学杂志,2017,16(12):1145-1148.
[17]廖焦鲁,樊沙沙,苟春雁,等.动留针术治疗寰枢关节寰齿前间隙狭窄型眩晕1例[J].实用中医药杂志,2017,33(1):86.
[2]史世鹏,刘春,黄小惠,等.泌尿系结石病因认识及综合预防[J].中国医学创新,2016,13(28):145-148.
[3]蒋伟芳.行气通腑合化瘀通淋法治疗尿路结石的临床疗效观察[J].中西医结合研究,2017,9(1):19-20,23.
[4]朱宇,陈能杰,朱红武.曲马多联合间苯三酚治疗肾绞痛53例临床观察[J].海峡药学,2008,20(11):78-79.
[5]江亮.浅述泌尿系结石的中医特效疗法[J].中国中医药现代远程教育,2010,8(23):167-169.
[6]梁会,袁国兴,蒋志平.快针并闪罐治疗泌尿系结石发作期疼痛疗效观察[J].中国中医急症,2015,24(3):497-498.
[7]宋小兵,赵剡,潘正启,等.吗啡分次注射联合间苯三酚治疗肾绞痛的疗效观察[J].临床急诊杂志,2011,12(3):147-148,150.
[8]王毅刚.动留针术的临床应用[J].南京中医学院学报,1992,44(4):110-111.
[9]王琴,黄小权,谢欣欣,等.关于疼痛患者的护理干预措施[J].实用临床护理学电子杂志,2018,3(51):194.
[10]陈敏,李赛美.电针郄募穴缓解肾绞痛及其伴随症状26例临床观察[J].中医杂志,2012,53(15):1308-1311.
[11]中华医学会.临床诊疗指南疼痛学分册巨[M].北京:人民卫生出版社,2007:19-21.
[12]毕军,陈玉中,朱成,等.疼痛评定与测量方法的研究[J].中国医疗器械信息,2017,23(2):6-8.
[13]李媛媛.古代中医石淋病史研究[D].北京:中国中医科学院,2010.
[14]谢云.华佗夹脊穴与临床应用[J].针灸临床杂志,2000,17(5):54-55.
[15]孙伊平,张娇娇,李婷,等.夹脊穴研究进展概述[J].长春中医药大学学报,2016,32(5):1092-1094.
[16]裴莹,赵雪,李忠正,等.钙离子与肥大细胞在针刺效应产生中作用的研究[J].临床和实验医学杂志,2017,16(12):1145-1148.
[17]廖焦鲁,樊沙沙,苟春雁,等.动留针术治疗寰枢关节寰齿前间隙狭窄型眩晕1例[J].实用中医药杂志,2017,33(1):86.