Jung Se Yun, Chae Hyun Dong, Kang Ung Rae, Kwak Min Ah, Kim In Hwan
Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea .
Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Korea .
J Gastric Cancer. 2017 Mar;17(1):11-20. doi: 10.5230/jgc.2017.17.e2. Epub 2017 Mar 9.
Acupuncture has recently been accepted as a treatment option for managing postoperative ileus (POI) and various functional gastrointestinal disorders. Therefore, we conducted a prospective randomized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery.
Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were randomly assigned to acupuncture or non-acupuncture (NA) groups at 1:1 ratio. The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1. The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph. The secondary outcome measure was the surgical outcome, including the times to first flatus, first defecation, start of water intake, and start of soft diet, as well as length of hospital stay and laboratory findings.
The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group. A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time (P<0.0001). The acupuncture group showed relatively better surgical outcomes than those in the NA group, but the differences were not statistically significant.
In this clinical trial, acupuncture promoted the passage of sitz markers, which may reflect the possibility of reducing POI after distal gastrectomy.
针灸最近已被公认为是治疗术后肠梗阻（POI）及各种功能性胃肠疾病的一种选择。因此，我们进行了一项前瞻性随机研究，以评估针灸对接受胃手术患者的POI及其他手术结局的影响。
2015年3月至12月期间接受远端胃癌切除术的36例患者按1:1比例随机分为针灸组和非针灸（NA）组。针灸治疗从术后第1天开始，每天进行1次，连续进行5天。主要观察指标是腹部X光片上小肠内残留 Sitz 标记物的数量。次要观察指标是手术结局，包括首次排气时间、首次排便时间、开始进水时间、开始进食软食时间，以及住院时间和实验室检查结果。
与NA组相比，针灸组在术后第3天和第5天小肠内的残留 Sitz 标记物明显更少。小肠内残留 Sitz 标记物的数量在组间差异随时间有显著差异（P<0.0001）。针灸组的手术结局相对比NA组更好，但差异无统计学意义。
在这项临床试验中，针灸促进了 Sitz 标记物的排出，这可能反映了远端胃切除术后降低POI的可能性。
