针刺对胸腔镜手术患者术后胃肠道恢复的疗效：一项前瞻性随机对照研究

WTW · 发表于 2023-10-17 00:38:22

Effectiveness of acupuncture for postoperative gastrointestinal recovery in patients undergoing thoracoscopic surgery: a prospective randomized controlled studyYingjun Zhang 1, Chaopeng Ou 1, Xiaolin Luo 1, Yinqian Kang 1, Li Jiang 2, Shaoyong Wu 1, Handong Ouyang 1

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PMID: 37800350
DOI: 10.1177/09645284231202807

Abstract

Background: Postoperative gastrointestinal dysfunction (PGD) is one of the most common complications among patients who have undergone thoracic surgery. Acupuncture has long been used in traditional Chinese medicine to treat gastrointestinal diseases and has shown benefit as an alternative therapy for the management of digestive ailments. This study aimed to explore the therapeutic effectiveness of acupuncture as a means to aid postoperative recovery of gastrointestinal function in patients undergoing thoracoscopic surgery.

Methods: In total, 112 patients aged 18-70 years undergoing thoracoscopic surgery between 15 June 2022 and 30 August 2022 were randomized into two groups. Patients in the acupuncture group (AG) first received acupuncture treatment 4 h after surgery, and treatment was repeated at 24 and 48 h. Patients in the control group (CG) did not receive any acupuncture treatment. Both groups received the same anesthetic protocol. Ultrasound-guided thoracic paravertebral block (TPVB) was performed in the paravertebral spaces between T4 and T5 with administration of 20 mL of 0.33% ropivacaine. All patients received patient-controlled intravenous analgesia (PCIA) after surgery.

Results: Median time to first flatus [interquartile range] in the AG was significantly less than in the CG (23.25 [18.13, 29.75] vs 30.75 [24.13, 45.38] h, p < 0.001). Time to first fluid intake after surgery was significantly less in the AG, as compared with the CG (4 [3, 7] vs 6.5 [4.13, 10.75] h, p = 0.003). Static pain, measured by visual analog scale (VAS) score, was significantly different on the third day after surgery (p = 0.018). Dynamic pain VAS scores were lower in the AG versus CG on the first three postoperative days (p = 0.014, 0.003 and 0.041, respectively).

Conclusion: Addition of acupuncture appeared to improve recovery of postoperative gastrointestinal function and alleviate posteoperative pain in patients undergoing thoracoscopic surgery. Acupuncture may represent a feasible strategy for the prevention of PGD occurrence.

Trial registration number: ChiCTR2200060888 (Chinese Clinical Trial Registry).

Keywords: acupuncture; gastrointestinal function; thoracoscopic surgery.

针刺对胸腔镜手术患者术后胃肠道恢复的疗效：一项前瞻性随机对照研究张英军1号，欧超鹏1号，罗晓林1号，康银倩1号，李江2号，吴绍勇1号，欧阳汉东1号附属关系扩展PMID:37800350 DOI:10.11177/09645284231202807摘要背景：术后胃肠功能障碍（PGD）是胸部手术患者最常见的并发症之一。针灸在传统中医中长期用于治疗胃肠道疾病，并已显示出作为治疗消化道疾病的替代疗法的益处。本研究旨在探讨针灸作为辅助胸腔镜手术患者术后胃肠功能恢复的有效性。方法：在2022年6月15日至2022年8月30日期间，共有112名年龄在18-70岁之间接受胸腔镜手术的患者被随机分为两组。针灸组（AG）患者在手术后4小时首次接受针灸治疗，并在24和48小时重复治疗。对照组（CG）患者未接受任何针灸治疗。两组接受相同的麻醉方案。在T4和T5之间的椎旁间隙进行超声引导的胸旁阻滞（TPVB），给药20mL 0.33%罗哌卡因。所有患者术后均接受患者自控静脉镇痛（PCIA）。结果：AG患者第一次出现胀气的中位时间[四分位间距]显著少于CG患者（23.25[18.13,29.75]vs 30.75[27.13,45.38]h，p<0.001）。与CG患者相比，AG患者术后第一次摄入液体的时间显著少于（4[3,7]vs 6.5[4.13，10.75]h，p=0.003）。通过视觉模拟量表（VAS）评分测量的静态疼痛，术后第三天有显著差异（p=0.018）。术后前三天，AG的动态疼痛VAS评分低于CG（分别为p=0.014、0.003和0.041）。结论：胸腔镜手术加用针刺有利于术后胃肠功能的恢复，减轻术后疼痛。针灸可能是预防PGD发生的一种可行策略。试验注册号：ChiCTR200060888（中国临床试验注册中心）。关键词：针灸；胃肠功能；胸腔镜手术。