Qiu Guotong, Huang Tao, Lu Yang, Zhang Lipeng, Zhao Yajie, Yuan Yong, Ren Hu, An Jun, Zhou Jincao, Li Rongjun, Du Yongxing, Wang Tuoran, Wang Peng, He Fang, Ding Yunqing, Zhang Jianwei, Han Bin, Lan Zhongmin, Qi Shulan, Li Zongze, Gao Jianyong, Gu Zongting, Sun Yuemin, Bai Xiaofeng, Aimaiti Saderbieke, Chu Yunmian, Wang Chengfeng
State Key Lab of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Ophthalmology, Acupuncture and Moxibustion Hospital of China Academy of Chinese Medicine Science, Beijing 100700, China.
Evid Based Complement Alternat Med. 2021 Mar 31;2021:5594263. doi: 10.1155/2021/5594263. eCollection 2021.
The effect of perioperative acupuncture on accelerating gastrointestinal function recovery has been reported in colorectal surgery and distal gastrectomy (Billroth-II). However, the evidence in pancreatectomy and other gastrectomy is still limited. A prospective, randomized controlled trial was conducted between May 2018 and August 2019. Consecutive patients undergoing pancreatectomy or gastrectomy in our hospital were randomly assigned to the electroacupuncture (EA) group and the control group. The patients in the EA group received transcutaneous EA on Bai-hui (GV20), Nei-guan (PC6), Tian-shu (ST25), and Zu-san-li (ST36) once a day in the afternoon, and the control group received sham EA. Primary outcomes were the time to first flatus and time to first defecation. In total, 461 patients were randomly assigned to the groups, and 385 were analyzed finally (EA group, = 201; control group, = 184). Time to first flatus (3.0 ± 0.7 vs 4.2 ± 1.0, < 0.001) and first defecation (4.2 ± 0.9 vs 5.4 ± 1.2, < 0.001) in the EA group were significantly shorter than those in the control group. Of patients undergoing pancreatectomy, those undergoing pancreaticoduodenectomy and intraoperative radiation therapy (IORT) surgery benefitted from EA in time to first flatus ( < 0.001) and first defecation ( < 0.001), while those undergoing distal pancreatectomy did not ( =0.157, =0.007) completely. Of patients undergoing gastrectomy, those undergoing total gastrectomy and distal gastrectomy (Billroth-II) benefitted from EA ( < 0.001), as did those undergoing proximal gastrectomy (=0.015). Patients undergoing distal gastrectomy (Billroth-I) benefitted from EA in time to first defecation (=0.012) but not flatus (=0.051). The time of parenteral nutrition, hospital stay, and time to first independent walk in the EA group were shorter than those in the control group. No severe EA complications were reported. EA was safe and effective in accelerating postoperative gastrointestinal function recovery. Patients undergoing pancreaticoduodenectomy, IORT surgery, total gastrectomy, proximal gastrectomy, or distal gastrectomy (Billroth-II) could benefit from EA. This trial is registered with NCT03291574.
围手术期针灸对加速结直肠手术和远端胃切除术（毕Ⅱ式）中胃肠功能恢复的作用已有报道。然而，在胰十二指肠切除术和其他胃切除术中的证据仍然有限。于2018年5月至2019年8月进行了一项前瞻性随机对照试验。在我院接受胰十二指肠切除术或胃切除术的连续患者被随机分为电针（EA）组和对照组。EA组患者于下午每天接受一次百会（GV20）、内关（PC6）、天枢（ST25）和足三里（ST36）的经皮电针治疗，对照组接受假电针治疗。主要结局指标为首次排气时间和首次排便时间。共有461例患者被随机分组，最终385例纳入分析（EA组201例；对照组184例）。EA组的首次排气时间（3.0±0.7天对4.2±1.0天，P<0.001）和首次排便时间（4.2±0.9天对5.4±1.2天，P<0.001）显著短于对照组。在接受胰十二指肠切除术的患者中，接受胰十二指肠切除术和术中放疗（IORT）手术的患者在首次排气时间（P<0.001）和首次排便时间（P<0.001）方面从EA中获益，而接受远端胰腺切除术的患者则未完全获益（P=0.157，P=0.007）。在接受胃切除术的患者中，接受全胃切除术和远端胃切除术（毕Ⅱ式）的患者从EA中获益（P<0.001），接受近端胃切除术的患者也是如此（P=0.015）。接受远端胃切除术（毕Ⅰ式）的患者在首次排便时间方面从EA中获益（P=0.012），但在排气时间方面未获益（P=0.051）。EA组的肠外营养时间、住院时间和首次独立行走时间均短于对照组。未报告严重的EA并发症。EA在加速术后胃肠功能恢复方面安全有效。接受胰十二指肠切除术、IORT手术、全胃切除术、近端胃切除术或远端胃切除术（毕Ⅱ式）的患者可从EA中获益。本试验已在NCT03291574注册。
