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成人周期性呕吐综合征伴心动过速的针灸和电针治疗:一例报告

Acupuncture and electroacupuncture for cyclic vomiting syndrome with tachygastria in an adult: A case report.

作者信息

Ha Na-Yeon, Kim Jinsung

机构信息

Division of Digestive Diseases, Department of Korean Internal Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Korean Medicine Hospital, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2024 Dec 20;103(51):e40830. doi: 10.1097/MD.0000000000040830.

Abstract

RATIONALE

Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of acute vomiting lasting <1 week, occurring independently and chronically. Management typically involves lifestyle interventions, supportive care, and preventative medication. In rare cases, CVS persists for decades in adults, requiring a multidisciplinary approach to improve symptoms and quality of life.

PATIENT CONCERNS

A 30-year-old male patient presented with a 7-year history of recurrent nausea and vomiting, which initially began in 2017. The episodes occurred without identifiable triggers such as alcohol or overeating, increasing in frequency from once every 4 months to 2 months. He expressed fear of severe deterioration, impacting his ability to eat freely, work, and enjoy his hobbies.

DIAGNOSES

He was diagnosed with CVS based on the Rome criteria. Cutaneous electrogastrography showed postprandial power decrease and tachygastria.

INTERVENTIONS

Regular acupuncture treatments, including electroacupuncture at ST36 with 3 Hz, were administered twice a week for 3 weeks, followed by weekly sessions for 5 additional weeks.

OUTCOMES

Over 11 treatment sessions across 8 weeks, no nausea or vomiting was observed. The visual analog scale (VAS) score for subjective gastrointestinal discomfort decreased from 67 to 0 after 4 weeks. The Nausea Severity Scale (NSS) score dropped from 14 to 0 after 4 weeks. The Functional Dyspepsia-related QoL score decreased from 16 to 0 after 8 weeks. The Nepean Dyspepsia Index-Korean version decreased from 80 to 8 after 8 weeks. Furthermore, the patient expressed high satisfaction with the treatment, and no adverse events were observed.

LESSONS

Acupuncture offers a significant and safe approach to relieving symptoms and enhancing the quality of life for patients with nausea and vomiting. Although this is a single case report, the findings suggest that acupuncture can improve treatment compliance and manage symptoms in adults with CVS. Further research, including clinical trials, is required to confirm these findings and understand the underlying mechanisms.

摘要

理论依据

周期性呕吐综合征(CVS)的特征是急性呕吐反复发作,持续时间小于1周,呈独立且慢性发作。治疗通常包括生活方式干预、支持性护理和预防性用药。在罕见情况下,CVS在成人中会持续数十年,需要多学科方法来改善症状和生活质量。

患者关注点

一名30岁男性患者有7年反复恶心和呕吐病史,最初始于2017年。发作无明显诱因,如酒精或暴饮暴食,发作频率从每4个月一次增加到每2个月一次。他担心病情严重恶化,影响其自由进食、工作和享受爱好的能力。

诊断

根据罗马标准,他被诊断为CVS。皮肤胃电图显示餐后功率下降和胃过速。

干预措施

每周进行两次常规针灸治疗,包括以3赫兹频率针刺足三里,共治疗3周,随后再进行5周每周一次的治疗。

结果

在8周内进行了11次治疗,未观察到恶心或呕吐。4周后,主观胃肠道不适的视觉模拟量表(VAS)评分从67降至0。4周后,恶心严重程度量表(NSS)评分从14降至0。8周后,功能性消化不良相关生活质量评分从16降至0。8周后,Nepean消化不良指数韩语版从80降至8。此外,患者对治疗表示高度满意,未观察到不良事件。

经验教训

针灸为缓解恶心和呕吐患者的症状及提高生活质量提供了一种有效且安全的方法。尽管这是一例单病例报告,但研究结果表明针灸可提高成人CVS患者的治疗依从性并控制症状。需要进一步研究,包括临床试验,以证实这些发现并了解其潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b620/11666160/e0fac3d68eb7/medi-103-e40830-g001.jpg

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