电针对胃镜检查不适的影响：一项随机对照试验。

Effect of electroacupuncture on discomfort during gastroscopy: A randomised controlled trial.

机构信息

Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.

International Education College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.

出版信息

Complement Ther Med. 2023 May;73:102936. doi: 10.1016/j.ctim.2023.102936. Epub 2023 Feb 28.

DOI:10.1016/j.ctim.2023.102936

PMID:36858243

Abstract

BACKGROUND

Gastrointestinal reactions, pain and discomfort are inevitable in patients undergoing common gastroscopy. Acupuncture is an effective therapy that assists in the perioperative period; however, evidence of it relieving discomfort is limited. We conducted this trial to observe the effect of electroacupuncture (EA) on discomfort caused by gastroscopy without sedatives.

METHODS

This was a single-centre, patient-assessor blind, randomised controlled trial. Sixty patients requiring gastroscopy were randomly assigned to the EA and control groups (sham acupuncture, SA, group) in a 1:1 ratio. Patients in the EA group underwent treatment at acupoints LI4 (Hegu), PC6 (Neiguan), ST36 (Zusanli), and ST34 (Liangqiu) for 30 min before gastroscopy, whereas patients in the SA group underwent superficial acupuncture at non-acupoints. The patients' nausea level, throat discomfort, bucking, and agitation were evaluated using a visual analogue scale (VAS) within 30 min after gastroscopy. The mean VAS score was the primary outcome. Secondary outcomes were the Amsterdam Preoperative Anxiety and Information Inventory Scale, used to evaluate patients' preoperative anxiety levels, and the 6-item State-Trait Anxiety Inventory (STAI-S6), used to assess anxiety before and after gastroscopy. The patients' vital signs, including heart rate, blood pressure, and pulse oxygen saturation, were recorded before, during, and after gastroscopy.

RESULTS

At 30 min after gastroscopy, the mean VAS score in the EA group (4.20 ± 0.63) was lower than that in the control group (5.14 ± 0.70, mean difference (MD): - 0.94, 95% confidence interval (CI): - 1.28, - 0.59, P < 0.001). There were statistically significant between-group differences in the nausea and vomiting, throat discomfort and agitation VAS scores (all P < 0.01), whereas no difference was found in the bucking VAS score (P = 0.692). Compared with the SA group, patients in the EA group had a 6.90-point lower in STAI-S6 (95% CI: -12.98, -0.81, P = 0.027) after gastroscopy. Patients in the EA group had a slower heart rate and lower blood pressure than those in the SA group. Serious adverse events were not observed during the trial.

CONCLUSION

EA can help relieve patients' anxiety, and improve their nausea and vomiting, throat discomfort, and agitation during gastroscopy.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR) ID: ChiCTR2000040726.

摘要

背景

接受普通胃镜检查的患者不可避免地会出现胃肠道反应、疼痛和不适。针刺是一种有效的辅助围手术期治疗方法，但缓解不适的证据有限。我们进行了这项试验，以观察电针对无镇静剂胃镜检查引起的不适的影响。

方法

这是一项单中心、患者评估者盲法、随机对照试验。将 60 名需要胃镜检查的患者以 1:1 的比例随机分配到电针（EA）组和对照组（假针刺，SA 组）。EA 组患者在胃镜检查前 30 分钟接受 LI4（合谷）、PC6（内关）、ST36（足三里）和 ST34（梁丘）穴位治疗，而 SA 组患者在非穴位进行浅针刺。使用视觉模拟量表（VAS）在胃镜检查后 30 分钟内评估患者的恶心程度、喉咙不适、躁动和躁动。平均 VAS 评分是主要结局。次要结局是阿姆斯特丹术前焦虑和信息量表，用于评估患者术前焦虑水平，以及状态-特质焦虑量表（STAI-S6），用于评估胃镜检查前后的焦虑水平。记录患者的生命体征，包括心率、血压和脉搏血氧饱和度，在胃镜检查前、中、后。

结果

胃镜检查后 30 分钟，EA 组（4.20±0.63）的平均 VAS 评分低于对照组（5.14±0.70，平均差值（MD）：-0.94，95%置信区间（CI）：-1.28，-0.59，P<0.001）。两组在恶心和呕吐、喉咙不适和躁动 VAS 评分方面存在统计学显著差异（均 P<0.01），而在躁动 VAS 评分方面无差异（P=0.692）。与 SA 组相比，EA 组患者术后 STAI-S6 评分降低 6.90 分（95%CI：-12.98，-0.81，P=0.027）。与 SA 组相比，EA 组患者的心率较慢，血压较低。试验过程中未观察到严重不良事件。