“三才刺”对肾绞痛患者血浆、尿液中P物质、5-羟色胺水平的影响

目的:通过观察不同针刺法对肾绞痛患者血浆、尿液中P物质(SP)、5-羟色胺(5-HT)水平的影响差异,探讨取得最佳效应的特异针刺手法及其作用机制。方法:将60例下焦瘀滞型肾绞痛患者随机分为治疗1组、治疗2组和对照组,每组20例,运用简化的McGill疼痛问卷量表对3组患者进行疼痛等级评分。治疗1组取肾俞穴,采用穴位分"天、人、地"三部刺入的"三才刺"法;治疗2组取阿是穴,针刺方法同治疗1组;对照组取肾俞穴,采用常规针刺法。共治疗30min。采用酶联免疫法测定血浆和尿液中SP和5-HT水平。结果:3组患者治疗后疼痛等级评分及血浆和尿液中SP、5-HT水平均明显下降,与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗1组和治疗2组治疗后疼痛等级评分及血浆和尿液中SP、5-HT水平与对照组比较明显降低(P<0.05)。结论:"三才刺"法对肾绞痛具有特异镇痛作用,其机制可能与减少血浆及尿液中SP、5-HT含量有关。

Influence of "Sancai" Acupuncture Treatment on Plasma and Urine SP, 5-HT Levels of Renal Colic Patients

Objective To observe the effect of "Sancai Needling"(superficial,medium and deep insertion of the acupuncture needle) combined with electroacupuncture(EA) stimulation of Shenshu(BL 23) on plasma and urine SP and 5-HT levels in renal colic patients,so as to study its mechanism underlying improvement of renal colic.Methods Sixty renal colic patients(lower-energizer stasis type) were randomly allocated to "Sancai Needling"-EA group,Ashi-point-EA group and routine EA treatment group,with 20 cases in each group.The "Sancai Needling"-EA meant that an acupuncture needle was inserted into the subcutaneous layer of BL 23 first and EA stimulation was given for 10 min;then the needle was inserted into the medium layer(muscle layer) and EA stimulation performed for 10 min;at last,the needle was further inserted into the periosteum-muscle layer and EA was performed for 10 min again.The procedures for Ashi-point-EA group were the same.For patients of the routine EA treatment group,EA was applied to BL 23 for 30 min.The therapeutic effect for pain was assessed according to McGill Pain Questionnaire.Plasma and urine SP and 5-HT contents were determined using enzyme-labeled immunosorbent assay(ELISA).Results In comparison with pre-treatment,pain scores,plasma and urine SP and 5-HT contents were remarkably decreased in renal colic patients of the "Sancai Needling"-EA group,Ashi-point-EA group and routine EA treatment group after the treatment(P<0.05).The effects of the "Sancai Needling"-EA group and Ashi-point-EA group were significantly superior to those of the routine EA treatment group in reducing pain score,plasma and urine SP and 5-HT contents(P<0.05).No statistical differences were found between the "Sancai Needling"-EA group and Ashi-point-EA group in pain score,plasma and urine SP and 5-HT contents(P>0.05).Conclusion "Sancai Needling"-EA treatment is effective in relieving renal colic in the patients,which may be closely associated with its effects in down-regulating plasma SP and 5-HT levels.