结肠镜检查期间针刺对结肠痉挛的抑制作用及安全性：一项随机对照试验

Suppression effect and safety of acupuncture on colonic spasm during colonoscopy: a randomized controlled trial.

作者信息

Chen Baoling, Ma Yanyan, Zhong Cailing, Li Ye, Mo Jiahao, Liang Songming, Zhong Yao, Zhang Beiping, Li Yingxian

机构信息

Department of Gastroenterology, Shunde Hospital of Guangzhou University of Chinese Medicine, Foshan, China.

The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

J Gastrointest Oncol. 2022 Jun;13(3):1169-1177. doi: 10.21037/jgo-22-407.

DOI:10.21037/jgo-22-407

PMID:35837181

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9274058/

Abstract

BACKGROUND

Intestinal spasm and peristalsis during colonoscopy are common but undesirable phenomena, which can easily lead to a missed diagnosis of colorectal polyps and other diseases, and antispasmodic drugs can have adverse side effects. Previous studies find that acupuncture can regulate abnormal gastrointestinal motility. But evidence quality is low and limited at present, and high-quality studies are required. So this study sought to explore the efficacy and safety of acupuncture in inhibiting colonic spasm during endoscopy.

METHODS

In this prospective, single-blinded, randomized controlled trial, 54 patients experiencing intestinal spasms during colonoscopy were randomly assigned to receive either acupuncture of the bilateral Hegu (LI 4) and Neiguan (PC 6) points (n=27) or sham acupuncture (n=27). The sham points were located 1 cm above the proximal end of the true points and had no known function. The primary outcome was the latency time to colonic spasm suppression, and the secondary outcomes were the duration of colonic spasm suppression, the proportion of patients with rebound spasms within 5 minutes, and adverse events related to acupuncture-related side effects.

RESULTS

A total of 54 patients were eligible, and 27 in each group. There was no significant difference in the background characteristics of the patients in the 2 groups. The latency time to spasm suppression of the treatment group was significantly shorter than that of the sham control group (acupuncture: 32.00 s . sham: 82.00 s; P<0.001). However, the duration of colonic spasm suppression was similar (acupuncture: 300 s . sham: 268 s; P=0.142). No rebound spasms were observed in the treatment group but rebound spasms were observed in 3 patients in the sham control group (acupuncture: 0% . sham: 11.1%; P=0.236). No adverse events were observed in either group.

CONCLUSIONS

Acupuncture of the bilateral Hegu (LI 4) and Neiguan (PC 6) points can shorten the latency time to spasm suppression, and may be used to suppress colonic spasm during colonoscopy.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2000037796.

摘要

背景

结肠镜检查期间肠道痉挛和蠕动是常见但不良的现象，容易导致结直肠息肉和其他疾病漏诊，且解痉药物可能有不良副作用。既往研究发现针刺可调节胃肠运动异常。但目前证据质量低且有限，需要高质量研究。因此，本研究旨在探讨针刺在内镜检查期间抑制结肠痉挛的有效性和安全性。

方法

在这项前瞻性、单盲、随机对照试验中，54例结肠镜检查期间出现肠道痉挛的患者被随机分配接受双侧合谷（LI 4）和内关（PC 6）穴位针刺（n = 27）或假针刺（n = 27）。假穴位位于真穴位近端上方1 cm处，无已知功能。主要结局是结肠痉挛抑制的潜伏时间，次要结局是结肠痉挛抑制的持续时间、5分钟内出现反弹痉挛的患者比例以及与针刺相关副作用的不良事件。

结果

共有54例患者符合条件，每组27例。两组患者的基线特征无显著差异。治疗组痉挛抑制的潜伏时间显著短于假对照组（针刺：32.00秒，假针刺：82.00秒；P<0.001）。然而，结肠痉挛抑制的持续时间相似（针刺：300秒，假针刺：268秒；P = 0.142）。治疗组未观察到反弹痉挛，但假对照组有3例患者出现反弹痉挛（针刺：0%，假针刺：11.1%；P = 0.236）。两组均未观察到不良事件。