腕踝针治疗急性胰腺炎即刻镇痛效果的随机对照研究

The Effect of Wrist and Ankle Needling in the Treatment of Acute Pancreatitis with Immediate Analgesia: A Randomized Controlled Trial

摘要: 目的：探讨腕踝针疗法(WAA)在急性胰腺炎(AP)患者中的镇痛效果、安全性及作用机制，为优化AP镇痛治疗提供新思路。方法：采用随机对照试验设计，纳入2023年8月至2024年10月福建中医药大学附属第二人民医院急诊科50例AP患者，随机分为对照组(布洛芬 + 常规治疗，n = 25)和WAA组(常规治疗 + WAA，n = 25)。对照组采用生长抑素、乌司他丁、布洛芬等药物联合镇痛；WAA组在常规治疗基础上，根据疼痛区域选取腕踝部特定穴位行浅刺治疗。通过NRS评分评估治疗前(T₀)、治疗后15分钟(T₁)、30分钟(T₂)、1小时(T₃)的疼痛程度，并比较两组临床疗效。结果：治疗后两组NRS评分均下降，但WAA组在T₂ (3.72 ± 1.17 vs. 4.68 ± 1.18)和T₃ (2.64 ± 1.15 vs. 3.52 ± 1.16)的评分显著低于对照组(均P < 0.05)。两组治疗后临床疗效的总体差异无统计学意义(χ² = 2.311, P = 0.315)，但治疗组在显效率(20.0% vs. 8.0%)和无效率(4.0% vs. 12.0%)方面均表现出优于对照组的趋势。结论：WAA作为AP的辅助治疗可显著增强镇痛效果，尤其在治疗后30分钟至1小时效果更优，且安全性良好，为AP镇痛提供了非药物干预的新选择。

Abstract: OBJECTIVE: To explore the analgesic effect, safety and mechanism of action of wrist and ankle acupuncture (WAA) in patients with acute pancreatitis (AP), and to provide new ideas for optimizing the analgesic treatment of AP. METHODS: A randomized controlled trial design was used to include 50 AP patients in the Emergency Department of the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from August 2023 to October 2024, and they were randomly divided into the control group (ibuprofen + conventional treatment, n = 25) and the WAA group (conventional treatment + WAA, n = 25). The control group was treated with growth inhibitors, ulinastatin and other drugs combined with analgesia; the WAA group was treated with superficial stabbing of specific acupoints at the wrist and ankle selected according to the pain area on the basis of conventional treatment. The pain level before treatment (T₀), 15 minutes (T₁), 30 minutes (T₂), and 1 hour (T₃) after treatment was evaluated by NRS score, and the clinical efficacy of the two groups was compared. RESULTS: NRS scores decreased in both groups after treatment, but the scores in the WAA group were significantly lower than those in the control group at T₂ (3.72 ± 1.17 vs. 4.68 ± 1.18) and T₃ (2.64 ± 1.15 vs. 3.52 ± 1.16) (both P < 0.05). The overall difference in clinical efficacy between the two treatment groups was not statistically significant (χ² = 2.311, p = 0.315), but the treatment group showed a trend of superiority over the control group in terms of both significant (20.0% vs. 8.0%) and ineffective (4.0% vs. 12.0%) rates. CONCLUSION: WAA as an adjunctive treatment for AP can significantly enhance the analgesic effect, especially better from 30 minutes to 1 hour after treatment, and has a favorable safety profile, providing a new option of non-pharmacological intervention for AP analgesia.