Analgesic Effects of Manual Acupuncture Versus Opioids andAntispasmodics in Patients With Biliary Colic: A ProspectiveObservational Study

Introduction: Pharmacologic interventions, including analgesics, are commonly employed to manage biliary pain. Nevertheless, evidence indicates that clinical pain management remains suboptimal, and certain patients may not achieve adequate analgesia due to contraindications or the need for opioid-sparing strategies. The present study aimed to investigate the analgesic efficacy of acupuncture at Yanglingquan (GB34) and Zusanli (ST36) in patients experiencing biliary colic. Methods: The prospective observational study comprised consecutive patients in the emergency department who presented with biliary colic and were diagnosed with cholecystitis between June 2016 and January 2017. Treatment allocation (acupuncture vs. control with analgesics) was determined based on the preferences of patients and clinicians rather than randomization. In the control group, patients received intramuscular anisodamine combined with bucinazine hydrochloride as the positive control analgesic intervention. Acupuncture was performed bilaterally at GB34 and ST36 for 20 minutes. Results: A total of 59 patients were included (29 acupuncture, 30 control). VAS scores significantly decreased from 6.66 ± 0.27 to 1.50 ± 0.26 in 30 min after acupuncture treatment. The acupuncture group had pain reduction with a considerably shorter onset time than the control group (0.66 ± 0.08 min vs. 12.90 ± 1.54 min, p＜0.0001). Additionally, the acupuncture group had a considerably greater percentage of total pain reduction than the control group (75.86% vs. 26.67%, p = 0.0006). No adverse events were reported. Discussion: This study demonstrates that manual acupuncture at GB34 and ST36 provides rapid and effective pain relief in patients with biliary colic, outperforming standard analgesic therapy in both onset time and degree of pain reduction. The mechanism may involve modulation of visceral pain pathways and autonomic regulation, which warrants further investigation. Conclusion: Acupuncture at GB34 and ST36 is a safe, rapid-onset, and decisive action for biliary colic. Its superiority over analgesics indicates a great application foreground in biliary diseases.