穴位注射联合中药热奄包外敷治疗输尿管结石性绞痛的临床疗效观察

Clinical Observation on the Efficacy of Acupoint Injection Combined with External Application of Chinese Herbal Hot Compresses for Ureteral Colic Caused by Ureteral Stones

摘要: 目的：探讨复方双氯芬酸钠注射液经穴位注射联合中药热奄包局部热敷治疗输尿管结石性肾绞痛的临床疗效。方法：纳入2025年1月至2025年6月于张家界市中医医院住院治疗的输尿管结石性肾绞痛患者70例，随机分为观察组与对照组各35例。对照组接受复方双氯芬酸钠常规肌肉注射，观察组则在相同药物基础上实施足三里穴位注射，并辅以中药热奄包双侧肾区与耻骨区热敷。对比两组患者的疼痛缓解程度、不良反应发生情况以及血清前列腺素E2 (PGE2)水平变化。结果：观察组在镇痛总有效率方面显著高于对照组(P < 0.05)。治疗前两组血清PGE2水平无显著差异(P > 0.05)，治疗后两组PGE2均降低，且观察组下降幅度大于对照组(P < 0.05)。治疗前两组疼痛视觉模拟评分(VAS)无统计学差异(P > 0.05)；治疗后10 min、30 min及60 min，两组VAS评分均下降，观察组在各时间点的降幅均较对照组更显著(P < 0.05)，观察组疼痛复发率、需补救镇痛的患者低于对照组(P < 0.05)，两组间不良反应发生率无显著差异(P > 0.05)。结论：复方双氯芬酸钠穴位注射联合中药热奄包热敷能有效缓解输尿管结石引起的绞痛，镇痛作用优于传统常规肌肉注射，且安全性较好。

Abstract: Objective: To evaluate the clinical efficacy of compound diclofenac sodium injection administered via acupoint injection combined with local heat application using traditional Chinese medicine hot compresses for the treatment of ureteral calculi-induced renal colic. Methods: Seventy patients with ureteral calculi-induced renal colic hospitalized at Zhangjiajie Traditional Chinese Medicine Hospital from January to June 2025 were enrolled and randomly divided into an observation group and a control group (35 patients each). The control group received conventional intramuscular injections of compound diclofenac sodium. The observation group received the same medication supplemented with acupoint injections at Zusanli (ST36) and warm compresses using traditional Chinese medicine poultices applied bilaterally to the renal and pubic regions. The two groups were compared in terms of pain relief efficacy, incidence of adverse reactions, and changes in serum prostaglandin E2 (PGE2) levels. Results: The total analgesic efficacy rate was significantly higher in the observation group than in the control group (P < 0.05). There was no significant difference in serum PGE2 levels between the two groups before treatment (P > 0.05). After treatment, PGE2 levels decreased in both groups, with a greater reduction in the observation group than in the control group (P < 0.05). There was no statistically significant difference in visual analog scale (VAS) pain scores between the two groups before treatment (P > 0.05). At 10 min, 30 min, and 60 min after treatment, VAS scores decreased in both groups, with the observation group showing a more significant reduction than the control group at each time point (P < 0.05). The recurrence rate of pain and the proportion of patients requiring rescue analgesia were lower in the observation group than in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Combined acupoint injection of compound diclofenac sodium with traditional Chinese medicine hot compresses effectively alleviates colic caused by ureteral stones. This approach demonstrates superior analgesic efficacy compared to conventional intramuscular injections while maintaining favourable safety profiles.