Acupuncture for response and complete pain relief time of acute renal colic: Secondary analysis of a randomized controlled trial

IF 2.8 4区 医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE Integrative Medicine Research Pub Date : 2024-01-20 DOI:10.1016/j.imr.2024.101021
Xue-Zhou Wang , Cun-Zhi Liu , Li-Qiong Wang , Zhi-Cheng Qu , Ying Cao , Shi-Yan Yan , Jing-Wen Yang , Jian-Feng Tu
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Abstract

Background

The integration of acupuncture with intramuscular injection of diclofenac sodium can expedite the onset of analgesia in treating acute renal colic caused by urolithiasis. However, it remains unclear whether acupuncture can accelerate pain relief constantly until complete remission. This study aimed to explore the extent to which acupuncture can expedite the onset time of response or complete pain relief in treating acute renal colic, and the predictive value of patient characteristics for treatment efficacy.

Methods

This secondary analysis utilized data from a prior randomized controlled trial. Eighty patients with acute renal colic were randomly assigned 1:1 to the acupuncture group or the sham acupuncture group. After intramuscular injection of diclofenac sodium, acupuncture or sham acupuncture was delivered to patients. The outcomes included time to response (at least a 50 % reduction in pain) and complete pain relief. Between-group comparison under the 2 events was estimated by Kaplan-Meier methodology. Subgroup analysis was performed utilizing the Cox proportional hazards model.

Results

The median response time and complete pain relief time in the acupuncture group were lower than those in the sham acupuncture group (5 vs 30 min, Log Rank P < 0.001; 20 min vs not observed, Log Rank P < 0.001, respectively). Hazard Ratios (HRs) for response across all subgroups favored the acupuncture group. All HRs for complete pain relief favored acupuncture, expect large stone and moderate pain at baseline. No interaction was found in either event.

Conclusion

Acupuncture can accelerate the response time and complete pain relief time for patients with acute renal colic, with the efficacy universally.

Trial registration

This study has been registered at Chinese Clinical Trial Registry: ChiCTR1900025202.

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针灸治疗急性肾绞痛的反应和完全止痛时间:随机对照试验的二次分析
背景 在治疗由尿路结石引起的急性肾绞痛时,针灸与肌肉注射双氯芬酸钠的结合可加快镇痛的开始。然而,针灸是否能持续加速疼痛缓解直至完全缓解仍不清楚。本研究旨在探讨针灸在治疗急性肾绞痛时能在多大程度上加快起效时间或完全缓解疼痛,以及患者特征对疗效的预测价值。80 名急性肾绞痛患者按 1:1 随机分配到针灸组或假针灸组。肌肉注射双氯芬酸钠后,对患者进行针灸或假针灸。结果包括反应时间(疼痛至少减轻 50%)和疼痛完全缓解。采用 Kaplan-Meier 方法估算 2 个事件下的组间比较。结果针灸组的反应时间和疼痛完全缓解时间低于假针灸组(分别为 5 分钟 vs 30 分钟,Log Rank P < 0.001;20 分钟 vs 未观察到,Log Rank P < 0.001)。所有分组的反应危险比(HRs)均倾向于针灸组。所有完全缓解疼痛的危险比都倾向于针灸组,预计大结石和基线中度疼痛。结论针灸可加快急性肾绞痛患者的反应时间和完全缓解疼痛的时间,疗效普遍。
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来源期刊
Integrative Medicine Research
Integrative Medicine Research Medicine-Complementary and Alternative Medicine
CiteScore
6.50
自引率
2.90%
发文量
65
审稿时长
12 weeks
期刊介绍: Integrative Medicine Research (IMR) is a quarterly, peer-reviewed journal focused on scientific research for integrative medicine including traditional medicine (emphasis on acupuncture and herbal medicine), complementary and alternative medicine, and systems medicine. The journal includes papers on basic research, clinical research, methodology, theory, computational analysis and modelling, topical reviews, medical history, education and policy based on physiology, pathology, diagnosis and the systems approach in the field of integrative medicine.
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