Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea.
Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang 10326, Republic of Korea.
J Integr Med. 2023 Nov;21(6):537-542. doi: 10.1016/j.joim.2023.10.004. Epub 2023 Nov 2.
Electroacupuncture (EA) may reduce the severity of acute pancreatitis (AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients with AP has not been well documented.
This study was undertaken to compare the pain-relieving effects of EA and conventional treatment in patients with AP.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This study was conducted using a randomized, controlled, three-arm, parallel-group and multi-center design. Patients diagnosed with AP were randomly and equally assigned to EA1, EA2 or control groups. All participants received conventional standard-of-care therapy for AP. Local EA alone was administered in EA1, and local plus distal EA was given in EA2. Local EA included two abdominal acupoints, while distal EA included twelve peripheral acupoints. EA groups underwent one session of EA daily for 4 days (days 1-4), or until pain was resolved or discharged.
The primary outcome measure was the change in the visual analogue scale (VAS; 0-100) pain score between baseline and day 5.
Eighty-nine participants were randomized into EA1, EA2 and control groups, and 88 (EA1, 30; EA2, 29; control, 29) were included in the full-analysis set. VAS score change (median [interquartile range]) on day 5 was (12.3 ± 22.5) in the EA1 group, (10.3 ± 21.5) in the EA2 group, and (8.9 ± 15.2) in the control group. There were not significant differences in the change in VAS score among treatments (P = 0.983). However, time to food intake was significantly shorter in the EA group (EA1 + EA2) than in the control group (median 2.0 days vs 3.0 days), with a hazard ratio of 0.581 (P = 0.022; 95% CI, 0.366-0.924). No significant adverse events occurred.
EA treatment did not significantly reduce pain after 4 days of treatment in patients with AP-associated abdominal pain but significantly reduced time to first food intake.
ClinicalTrials.gov identifier NCT03173222. Please cite this article as: Jang DK, Lee JK, Jung CY, Kim KH, Kang HR, Lee YS, Yoon JH, Joo KR, Chae MK, Baek YH, Seo BK, Lee SH, Lim C. Electroacupuncture for abdominal pain relief in patients with acute pancreatitis: A three-arm randomized controlled trial. J Integr Med. 2023; 21(6): 537-542.
电针（EA）可能减轻急性胰腺炎（AP）的严重程度，并为慢性胰腺炎患者提供额外的疼痛缓解。然而，EA 缓解 AP 患者疼痛的能力尚未得到很好的记录。
本研究旨在比较 EA 和常规治疗在 AP 患者中的止痛效果。
设计、地点、参与者和干预措施：本研究采用随机、对照、三臂、平行组和多中心设计进行。诊断为 AP 的患者被随机分为 EA1、EA2 或对照组。所有参与者均接受 AP 的常规标准治疗。EA1 仅接受局部 EA，EA2 接受局部加远端 EA。局部 EA 包括两个腹部穴位，远端 EA 包括 12 个外周穴位。EA 组每天接受一次 EA，持续 4 天（第 1-4 天），或直至疼痛缓解或出院。
主要观察指标是基线至第 5 天视觉模拟量表（VAS；0-100）疼痛评分的变化。
89 名参与者被随机分配至 EA1、EA2 和对照组，88 名（EA1，30 名；EA2，29 名；对照组，29 名）被纳入全分析集。第 5 天 VAS 评分变化（中位数[四分位距]）在 EA1 组为（12.3±22.5），在 EA2 组为（10.3±21.5），在对照组为（8.9±15.2）。治疗之间 VAS 评分变化无显著差异（P=0.983）。然而，EA 组（EA1+EA2）的首次进食时间明显短于对照组（中位数 2.0 天 vs 3.0 天），风险比为 0.581（P=0.022；95%CI，0.366-0.924）。未发生明显不良事件。
在接受 AP 相关腹痛治疗的 4 天后，EA 治疗并未显著减轻疼痛，但显著缩短了首次进食的时间。
ClinicalTrials.gov 标识符 NCT03173222。请引用本文作为：Jang DK, Lee JK, Jung CY, Kim KH, Kang HR, Lee YS, Yoon JH, Joo KR, Chae MK, Baek YH, Seo BK, Lee SH, Lim C. 电针对急性胰腺炎患者腹痛缓解的作用：一项三臂随机对照试验。综合医学杂志。2023;21(6):537-542.
