Comparative efficacy of acupressure and magnetic therapy vs. diclofenac sodium for pain management in upper urinary tract calculi

PURPOSE: To compare the analgesic efficacy of acupressure and magnetic therapy (AMT) versus diclofenac sodium (DFS) in acute renal colic and identify factors influencing therapeutic outcomes. METHODS: A total of 138 patients with acute renal colic (visual analog scale [VAS] score ≥ 7) were randomized to AMT or DFS treatment. Primary endpoints included changes in VAS scores at baseline, 1-, 10-, 30-, and 120-min post-intervention, along with analgesic duration. Multiple linear regression evaluated the influence of treatment modality, gender, white blood cell (WBC) count, and other covariates on VAS scores at 10 min. Interaction effect analysis was additionally used to assess how these factors modified treatment efficacy. RESULTS: The AMT group demonstrated rapid onset, achieving an 86 % VAS reduction at 1-min post-intervention (vs. baseline, P < 0.001), though pain rebound occurred after 30 min. The DFS group exhibited slower onset but significantly prolonged analgesic duration compared to AMT (23.6 ± 2.2 h vs. 2.4 ± 1.0 h, P < 0.001). Multiple linear regression revealed that AMT had the best analgesic effect (B = -6.22, P < 0.001). Male gender (B = 0.78, P = 0.026) and lower baseline WBC counts (B = -0.16, P = 0.026) were associated with higher VAS scores. Interaction analysis indicated enhanced AMT efficacy in male patients and those with lower WBC counts. CONCLUSIONS: AMT and DFS exhibit complementary "rapid-sustained" analgesic profiles in renal colic management, with gender and WBC levels significantly modulating treatment efficacy. A stratified analgesia protocol based on these factors may optimize patient outcomes.