比較針刺和Meperidine對急性尿路結石痛病患之止痛效果

Acupuncture Versus Meperidine in the Treatment of Renal Colic

林秋梅(Chiu-Mei Lin) ； 林朝順(Chaou-Shune Lin) ； 王宗倫(Tzong-Luen Wang) ； 張珩(Hang Chang)

《中華民國急救加護醫學會雜誌》 13卷1期 (2002/03) Pp. 18-25

https://doi.org/10.30018/JECCM.200203.0003

摘要

急性尿路結石痛病患在急診各色各樣病患中是常見的族群。針刺治療疼痛是中國人不管遠古或現廣為接受而且療效確立的止痛方式，可惜目前仍無人嘗試用於急性尿路結石痛之急診病患；毋庸置疑地，理想的止痛方式是迅速有效並且少副作用療程。本實驗之目的是評保針刺止痛在急診尿路結石痛病人應用的效果，利用麻醉性止痛劑（meperidine,demerol）之「方便劑量（50mg）」做為對照組，比較兩者的止痛效果，作用和安全性，以10cm-visual analogue scale （VAS）疼痛指數為評估基礎。結果顯示針刺組疼痛指數在治療前，以及15分鐘和30分鐘時由73.2±11.6mm（95% confidence intervals CI, 61.6-84.8）降為42.5±13.3mm（95%CI,2932-55.8）（P＜0.05）和33.4±14.6mm（95%CI,18.8-48.0）（P＜0.05），而meperidine組在15分鐘和30分鐘時疼痛指數分別是75.7±5.5mm（95CI,70.2-81.2）降為50.2±12.5mm（95%CI,37.7-62.7）（P＜0.05）。兩者止痛效果並沒有顯著之差異。但是在副作用方面meperidine組多於針刺組。

關鍵字

結石痛 ； 針刺

並列摘要

To compare the analgesic efficacy of acupuncuture versus meperidine in the treatment of acute renal colic.A prospective trial was carried out. Patients 18 to 75 years of age with pain suggestive of renal colic were eligible for entry into the study. Exclusions included pregnant women and patients with a history of renal or hepatic impairment, hypertension, diabetes ,or hypersensitivity to meperidine. Subjects were randomly assigned to receive (1) acupuncture by inserting disposable, sterile needles over five points on the back or (2) a single intramuscular injection of 50 mg meperidine (Demerol). Pain assessment was made using a 10 cm-visual analongue scale before treatment and 15 and 30 minutes after treatment. Forty-six patients were entered the study. Only data from those patients with stones confirmed by intravenous pyelogram and /or ultrasound scan were analyzed . Six patients could not be evaluated. Of the remaining 40 patients, the main pain score (± confidence interval , 95%CI) for the acupuncture group decreased from 73.2±11.6 mm (95%CI,61.6-84.4) to 42.5±13.3mm (95%CI,29.2-55.8)(p＜0.05) and 33.4±14.6 mm (95%CI,18.8-48.0) (p＜0.05) at 15 and 30 minutes, respectively . The main pain score (±95%CI) for the meperidine group had decreased from 75.7±5.5 mm (95%CI,70.2-81.2) to 50.2±12.5 mm (95%CI,37.7-62.7) (p＜0.05) and 36.5±13.9 mm (95%CI,22.6-50.4) (p＜0.05) at 15and 30 minutes, respectively. The difference between the two groups was not significant. Conclusion: There is no significant difference between acupuncture and intramuscular meperidine in the perceived relief of pain from renal colic.

並列關鍵字

renal colic ； acupuncture ； meperidine