Matsumoto-Miyazaki Jun, Asano Yoshitaka, Takei Hiroaki, Ikegame Yuka, Shinoda Jun
Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, Minokamo, Gifu, Japan.
Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Minokamo, Gifu, Japan.
Med Acupunct. 2019 Aug 1;31(4):218-223. doi: 10.1089/acu.2019.1361. Epub 2019 Aug 19.
Patients with chronic disorders of consciousness (DOC) frequently develop chronic constipation. This study evaluated the effects of acupuncture on bowel movements (BMs) in patients with DOC and chronic constipation resulting from severe traumatic brain injury (TBI). This retrospective observational study took place in the Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, of Kizawa Memorial Hospital, in Minokamo, Gifu, Japan. The study included 25 patients with chronic DOC resulting from TBI, who received acupuncture treatment. The patients received 2 sessions of acupuncture treatment per week. Information on frequency of defecation, number of days during which patients had BMs, and use of laxatives prior to the acupuncture treatment and after 10 weeks of treatment was extracted from medical records and compared. The median (first quartile and third quartile) frequency of defecation increased significantly after 10 weeks of acupuncture from 3.0 (2.5, 3.5) to 3.5 (2.5, 4.5) times/week ( = 0.038). The number of days on which defecation occurred also increased significantly, from 2.0 (2.0, 2.5) to 2.5 (2.0, 3.5) days/week ( < 0.001). The use of bisacodyl suppositories decreased significantly from 1.5 (1.5, 2.0) to 1.5 (0.5, 2.0) times/week ( = 0.041). The mean ± standard error use of sodium picosulfate for 10 patients decreased significantly, from 20.4 ± 3.5 to 14.3 ± 3.3 drops/week ( = 0.004). Acupuncture treatment could be beneficial for chronic constipation in patients with DOC caused by TBI. A large prospective cohort study with a control group is warranted.
慢性意识障碍(DOC)患者常出现慢性便秘。本研究评估了针刺对DOC患者以及因重度创伤性脑损伤(TBI)导致的慢性便秘患者排便的影响。这项回顾性观察研究在日本岐阜县美浓加茂市木泽纪念医院的中部创伤性脑功能障碍医学中心进行。该研究纳入了25例因TBI导致慢性DOC并接受针刺治疗的患者。患者每周接受2次针刺治疗。从医疗记录中提取针刺治疗前及治疗10周后患者的排便频率、有排便的天数以及泻药使用情况等信息并进行比较。针刺治疗10周后,排便频率中位数(第一四分位数和第三四分位数)从3.0(2.5,3.5)次/周显著增加至3.5(2.5,4.5)次/周(P = 0.038)。排便天数也显著增加,从2.0(2.0,2.5)天/周增至2.5(2.0,3.5)天/周(P < 0.001)。比沙可啶栓剂的使用频率从1.5(1.5,2.0)次/周显著降至1.5(0.5,2.0)次/周(P = 0.041)。10例患者的聚乙二醇4000硫酸钠平均使用量(均值±标准误)从20.4 ± 3.5滴/周显著降至14.3 ± 3.3滴/周(P = 0.004)。针刺治疗可能对TBI所致DOC患者的慢性便秘有益。有必要开展一项设对照组的大型前瞻性队列研究。