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针刺缓解低位单纯性肛瘘患者术后疼痛的疗效:一项前瞻性随机对照试验方案

The efficacy of acupuncture in relieving postoperative pain in patients with low simple anal fistula: Protocol of a prospective, randomised, controlled trial.

作者信息

Yang Min, Zheng De, Jin Xingtao, Tang Huili, Cao Weiwei, Ye Qianqian, Qu Yin, Mei Zubing

机构信息

Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Anorectal Disease Institute of Shuguang Hospital, Shanghai, China.

出版信息

PLoS One. 2025 Jan 24;20(1):e0317902. doi: 10.1371/journal.pone.0317902. eCollection 2025.

Abstract

BACKGROUND

Anal fistula surgery often leads to postoperative pain, which can hinder recovery and negatively impact patients' quality of life. This prospective, randomised, controlled trial (RCT) aims to investigate the efficacy of acupuncture in alleviating postoperative pain and reducing the usage of analgesic medications following anal fistula surgery.

METHODS

This single-centre, patient-blinded, assessor-blinded, placebo-controlled randomised controlled trial (RCT) will be conducted at a tertiary referral hospital. A total of 66 patients with low simple anal fistula will be randomised at a 1:1 ratio to receive either acupuncture or sham acupuncture. The primary outcome is the difference in the numerical rating scale (NRS) pain score before and after acupuncture at 6 hours post surgery. The secondary outcomes include postoperative analgesic usage (Day 0 to Day 7), complications (including infection, urinary retention, and bleeding from Day 0 to Day 7, as well as delayed wound healing and recurrence within 3 months post surgery), sleep quality (PSQI from Day 0 to Day 7), psychological state (SDS and SAS on Day 0, Day 1, and Day 7), and overall recovery quality (QoR-15 on Day 1, Day 3, and Day 7). The statistical analysis of this trial will be conducted using SPSS software, validating the normality of data and the homogeneity of variance, and employing t-tests, Mann-Whitney U tests, chi-square tests, and repeated measures ANOVA to analyze baseline data, primary and secondary outcome indicators.

DISCUSSION

This study aims to contribute to the expanding evidence base regarding the role of acupuncture in postoperative pain management. Through a comprehensive assessment of pain relief, analgesic usage, and other recovery-related outcomes, our findings will establish a foundation for standardizing acupuncture protocols specifically tailored for anal fistula surgery patients. The strengths of this trial are rooted in its rigorous randomised controlled trial (RCT) design, comprehensive outcome measures, and focused examination of a clinically significant issue. Ultimately, the findings of this trial have the potential to offer valuable insights into the utility of acupuncture as an adjunctive therapy for postoperative pain management among anal fistula patients, thereby informing future clinical practice and research directions.

TRIAL REGISTRATION

This study was registered in the China Clinical Trial Registry on June 1, 2024, with registration number: ChiCTR2400085178.

摘要

背景

肛瘘手术常导致术后疼痛,这可能会阻碍恢复并对患者的生活质量产生负面影响。这项前瞻性、随机、对照试验(RCT)旨在研究针刺在减轻肛瘘手术后疼痛及减少镇痛药使用方面的疗效。

方法

这项单中心、患者盲法、评估者盲法、安慰剂对照的随机对照试验(RCT)将在一家三级转诊医院进行。总共66例低位单纯性肛瘘患者将按1:1的比例随机分组,分别接受针刺或假针刺治疗。主要结局是术后6小时针刺前后数字评分量表(NRS)疼痛评分的差异。次要结局包括术后镇痛药使用情况(术后第0天至第7天)、并发症(包括术后第0天至第7天的感染、尿潴留和出血,以及术后3个月内的伤口愈合延迟和复发)、睡眠质量(术后第0天至第7天的PSQI)、心理状态(术后第0天、第1天和第7天的SDS和SAS)以及总体恢复质量(术后第1天、第3天和第7天的QoR - 15)。本试验的统计分析将使用SPSS软件进行,验证数据的正态性和方差齐性,并采用t检验、曼 - 惠特尼U检验、卡方检验和重复测量方差分析来分析基线数据、主要和次要结局指标。

讨论

本研究旨在为针刺在术后疼痛管理中的作用不断扩大的证据基础做出贡献。通过对疼痛缓解、镇痛药使用及其他与恢复相关结局的全面评估,我们的研究结果将为为肛瘘手术患者量身定制的针刺方案标准化奠定基础。本试验的优势在于其严格的随机对照试验(RCT)设计、全面的结局指标以及对一个具有临床意义问题的重点研究。最终,本试验的结果有可能为针刺作为肛瘘患者术后疼痛管理辅助治疗的效用提供有价值的见解,从而为未来的临床实践和研究方向提供参考。

试验注册

本研究于2024年6月1日在中国临床试验注册中心注册,注册号:ChiCTR2400085178。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f354/11761113/bd256251a2b0/pone.0317902.g001.jpg

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