Objective

2

To observe the effectiveness of acupuncture at the Yaotong dian（EX-UE7） in the treatment of acute renal colic caused by urinary tract stones and explore its mechanism of action from a metabolomics perspective.

Methods

2

This study was an exploratory prospective randomized controlled trial. 20 patients with acute renal colic due to urolithiasis were randomly divided into an experimental group（10 cases） and a control group（10 cases）. The experimental group received acupuncture at the bilateral Yaotongdian（EX-UE7）. The control group was treated with nonpoint shallow puncture. The outcome was the response rate at 10 minutes after needle manipulation. The nontargeted metabolomics method of chromatography-mass spectrometry was used to detect the metabolites in each group of samples before and after treatment. The detected metabolites were differentiated according to

P

value， difference multiple change and the projected importance value of calculated variables， and the Spearman correlation coefficient was used to combine with clinical indicators for further screening of differential metabolites. Functional pathway enrichment analysis was done based on the KEGG database.

Results

2

The experimental group benefited from higher response rate of 80.0% at 10 minutes than the control group（95% CI，38.4%~94.3%，

P

<

0.01）. In terms of metabolomics， 199 differential metabolites were screened before and after treatment in the experimental group； 54 differential metabolites were screened before and after treatment in the cont

rol group. Compared with the experimental group， 325 different metabolites were screened from the control group. Spearman level correlation analysis was performed on the changes in metabolites and NRS pain scores before and after treatment in the experimental group， the results showed that 4 different metabolites including guanosine were negatively correlated with NRS pain scores. 9 different metabolites including Albaflavenone were positively correlated with the NRS pain scores. Spearman correlation analysis was conducted between the changes in metabolites in the control group and those in the experimental group and the NRS pain scores. The results showed that 3 different metabolites including 3-aldehyde salicylic acid were negatively correlated with the NRS pain scores. 8 different metabolites including Cortisol were positively correlated with the NRS pain scores. Compared with the control group， the experimental group was enriched in 9 pathways， among which the pathways related to pain regulation were the tryptophan metabolism pathway and unsaturated fatty acid biosynthetic metabolism pathway.

Conclusion

2

Acupuncture at the bilateral Yaotongdian（EX-UE7） can be considered an effective therapy in relieving acute renal colic caused by urinary tract stones. Guanine， guanosine， cortisol different metabolites are associated with changes in pain， and tryptophan metabolic pathways and unsaturated fatty acid biosynthesis pathways also participates in the regulation of pain， which may be the potential mechanism of acupuncture in the treatment of renal colic.