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经皮穴位电刺激(TEAS)对胃癌患者术后恢复的影响:一项随机对照试验

Effects of Transcutaneous Electrical Acupoint Stimulation (TEAS) on Postoperative Recovery in Patients with Gastric Cancer: A Randomized Controlled Trial.

作者信息

Zhou Xin, Cao Shou-Gen, Tan Xiao-Jie, Liu Xiao-Dong, Li Ze-Qun, Kong Ling-Xin, Tian Yu-Long, Liu Dan, Shen Shuai, Sun Yu-Qi, Jiang Hai-Tao, Zhou Yan-Bing

机构信息

Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China.

Department of Rehabilitation, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China.

出版信息

Cancer Manag Res. 2021 Feb 12;13:1449-1458. doi: 10.2147/CMAR.S292325. eCollection 2021.

Abstract

PURPOSE

Transcutaneous electrical acupoint stimulation (TEAS) is an innovative choice for postoperative pain management. However, the safety and effectiveness of this traditional Chinese medicine (TCM) therapy for patients who underwent gastrectomy is largely unknown. So, the purpose of this study is to evaluate the safety and effectiveness of TEAS for patients who underwent gastrectomy.

PATIENTS AND METHODS

We recruited 96 patients with gastric cancer from May 2019 to November 2019; 82 patients were enrolled, and 81 patients completed. Patients were randomly assigned to TEAS group (TG) received TEAS on postoperative day (POD) 1-3 or control group (CG) at a 1:1 ratio. The primary outcomes were pain score and consumption of analgesics. The secondary were the time of first postoperative flatus and defecation, frequency of postoperative nausea, vomiting, distention, diarrhea, comfort of semi-fluid diet, Clavien-Dindo grade (C-D grade) and length of postoperative day. We performed hematological analysis to explore the possible mechanisms.

RESULTS

Overall, 81 patients were enrolled included in the analysis. Compared with CG, pain scores in TG were lower on POD 1-5 (average: 2.55±0.21 vs 3.10±0.42, <0.001), and the use rate of opioids was lower (43.9 vs 75.0, =0.004); time of first postoperative flatus (55.63±16.74 vs 72.60±20.92, <0.001) and defecation (72.20±16.24 vs 95.78±17.75, <0.001) were shorter; the frequency of nausea were fewer (1.88±1.09 vs 2.58±0.77, =0.029) and patients were more comfortable with semi-fluid diet (7.63±0.63 vs 6.93±0.69, <0.001); among the hematologic results, β-endorphin (β-End), interleukin-2 (IL-2), motilin (MTL) on POD 3, POD 5 were lower, 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) were higher. And no adverse event was reported.

CONCLUSION

TEAS can relieve postoperative pain and promote the recovery of gastrointestinal function. Consequently, it can be an adjunctive therapy to enhance postoperative recovery for patients after gastrectomy.

摘要

目的

经皮穴位电刺激(TEAS)是术后疼痛管理的一种创新选择。然而,这种中医疗法对接受胃切除术患者的安全性和有效性在很大程度上尚不清楚。因此,本研究的目的是评估TEAS对接受胃切除术患者的安全性和有效性。

患者与方法

我们在2019年5月至2019年11月招募了96例胃癌患者;82例患者入组,81例患者完成研究。患者按1:1比例随机分为术后第1 - 3天接受TEAS的TEAS组(TG)或对照组(CG)。主要结局指标为疼痛评分和镇痛药消耗量。次要指标为首次术后排气和排便时间、术后恶心、呕吐、腹胀、腹泻的频率、半流质饮食舒适度、Clavien-Dindo分级(C-D分级)和术后住院天数。我们进行血液学分析以探索可能的机制。

结果

总体而言,81例患者纳入分析。与CG组相比,TG组在术后第1 - 5天疼痛评分更低(平均:2.55±0.21 vs 3.10±0.42,<0.001),阿片类药物使用率更低(43.9 vs 75.0,=0.004);首次术后排气时间(55.63±16.74 vs 72.60±20.92,<0.001)和排便时间(72.20±16.24 vs 95.78±17.75,<0.001)更短;恶心频率更少(1.88±1.09 vs 2.58±0.77,=0.029),患者对半流质饮食更舒适(7.63±0.63 vs 6.93±0.69,<0.001);在血液学结果中,术后第3天、第5天的β-内啡肽(β-End)、白细胞介素-2(IL-2)、胃动素(MTL)更低,5-羟色胺(5-HT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)更高。且未报告不良事件。

结论

TEAS可缓解术后疼痛并促进胃肠功能恢复。因此,它可作为一种辅助治疗方法,以促进胃切除术后患者的术后恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4b/7886100/03c801f0e6c5/CMAR-13-1449-g0001.jpg

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