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Volume 14 Issue 5
Sep.  2023
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LI Tianyu, ZHANG Yamin, MI Qindong, LI Zeru, BAO Fei, WANG Weibin. Comparison of Clinical Efficacy of Different Acupuncture Therapies for Grade C Delayed Gastric Emptying after Pancreaticoduodenectomy: A Retrospective Cohort Study Based on Propensity Score Matching[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1031-1037. DOI: 10.12290/xhyxzz.2023-0088
Citation: LI Tianyu, ZHANG Yamin, MI Qindong, LI Zeru, BAO Fei, WANG Weibin. Comparison of Clinical Efficacy of Different Acupuncture Therapies for Grade C Delayed Gastric Emptying after Pancreaticoduodenectomy: A Retrospective Cohort Study Based on Propensity Score Matching[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1031-1037. DOI: 10.12290/xhyxzz.2023-0088
shu

Comparison of Clinical Efficacy of Different Acupuncture Therapies for Grade C Delayed Gastric Emptying after Pancreaticoduodenectomy: A Retrospective Cohort Study Based on Propensity Score Matching

  • 1.

    Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

National High Level Hospital Clinical Research Funding 2022-PUMCH-B-004

Peking Union Medical College Hospital Precipitation Fund Integration Entrusted Project ZC201903189

More Information
  • Corresponding author:

    BAO Fei, E-mail: bfpumch@163.com

    WANG Weibin, E-mail: wwb_xh@163.com

  • Received Date: February 16, 2023
  • Accepted Date: March 27, 2023
  • Issue Publish Date: September 29, 2023
    Graphical Abstract
    • Abstract
  •   Objective  To investigate the effect of different acupuncture methods on gastric juice drainage in patients with grade C delayed gastric emptying (DGE) after pancreaticoduodenectomy.
      Methods  This was a retrospective cohort study of patients with grade C DGE after pancreaticoduodenectomy who received acupuncture treatment from January 2015 to September 2021. According to the acupuncture methods, the patients were divided into body acupuncture group and ear-body acupuncture group. The patients in both groups were matched 1∶1, using propensity score matching based on the baseline gastric fluid drainage. The differences in the primary outcome indicators[short-term (within 3 d) outcome, long-term (within 10 d) outcome] and secondary outcome indicators (length of postoperative hospital stay, proportion of patients discharged with a gastric tube, incidence of adverse events during treatment) were compared between the two groups.
      Results  A total of 65 patients with DGE who met the inclusion and exclusion criteria were enrolled, including 34 patients (52.3%) in the ear-body acupuncture group and 31 patients (47.7%) in the body acupuncture group. (1)Short-term efficacy: A total of 23 patients in the ear-body acupuncture group and 23 patients in the body acupuncture group were enrolled after matching by propensity score method. The short-term decrease rate of gastric fluid drainage in the ear-body acupuncture group was higher than that in the body acupuncture group[42.7%(19.6%, 65.1%) vs. 6.5%(-14.7%, 50.6%), P=0.034]. (2) Long-term efficacy and secondary outcome indicators: There were 4 and 6 patients in the body acupuncture group and the ear-body acupuncture group, respectively, who had their gastric tubes successfully removed within 3 d of treatment. Their long-term efficacy of treatment could not be calculated, so they were excluded. After matching the two groups again using the propensity score method, a total of 16 patients in the ear-body acupuncture group and 16 patients in the body acupuncture group were included. There were no adverse events during treatment in both groups, and the rate of long-term gastric drainage decline was higher in the ear-body acupuncture group [49.6% (15.7%, 56.9%) vs. 8.8%(-9.3%, 33.1%), P=0.024] than the body acupuncture group, the postoperative hospital stay[30.0(26.0, 38.5) d vs. 31.0(24.3, 43.8) d, P=0.748] and the proportion of patients discharged with a gastric tube (18.8% vs. 25.0%, P > 0.999) were not significantly different between the two groups.
      Conclusion  Compared with body acupuncture alone, auricular acupuncture combined with body acupuncture therapy is more effective in reducing gastric drainage in patients with grade C DGE after pancreaticoduodenectomy, which may be beneficial to patients' postoperative recovery.
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    • References (32)
  • [1]
    Karim SAM, Abdulla KS, Abdulkarim QH, et al. The outcomes and complications of pancreaticoduodenectomy (Whipple procedure): Cross sectional study[J]. Int J Surg, 2018, 52: 383-387. DOI: 10.1016/j.ijsu.2018.01.041
    [2]
    Cai X, Zhang M, Liang C, et al. Delayed gastric emptying after Pancreaticoduodenectomy: a propensity score-matched analysis and clinical Nomogram study[J]. BMC Surg, 2020, 20: 149. DOI: 10.1186/s12893-020-00809-5
    [3]
    Qu H, Sun GR, Zhou SQ, et al. Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy: a systematic review and meta-analysis[J]. Eur J Surg Oncol, 2013, 39: 213-223. DOI: 10.1016/j.ejso.2012.12.010
    [4]
    葛佳伊, 姜跃炜, 王东煜, 等. 温针灸对糖尿病胃轻瘫患者胃肠激素的影响[J]. 中华全科医学, 2016, 14: 298-299, 316. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201602048.htm
    [5]
    王蕊, 杨正飞. 针灸治疗糖尿病胃轻瘫作用机制探析[J]. 山东中医杂志, 2022, 41: 370-375. https://www.cnki.com.cn/Article/CJFDTOTAL-SDZY202204003.htm
    [6]
    张保良. 中药加针灸治疗食管癌、贲门癌术后胃瘫综合征临床研究[J]. 中外医学研究, 2010, 8: 59. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201724020.htm
    [7]
    朱伟坚, 王茵萍, 高岑, 等. 电针预防胰十二指肠切除术后胃瘫综合征的临床观察[J]. 世界中西医结合杂志, 2021, 16: 162-166. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202101036.htm
    [8]
    中华医学会外科学分会胰腺外科学组, 中国研究型医院学会胰腺病专业委员会. 胰腺术后外科常见并发症诊治及预防的专家共识(2017)[J]. 协和医学杂志, 2017, 8: 139-146. DOI: 10.3969/j.issn.1674-9081.2017.03.011
    [9]
    None. Auricular Acupuncture Point (WFAS STANDARD-002: 2012)[J]. World J Acupunct Mox, 2013, 23: 12-21. DOI: 10.1016/S1003-5257(13)60055-0
    [10]
    罗国德, 曹永宽, 张林, 等. 胃液引流量在腹部术后胃瘫综合征中的诊断价值及其影响因素(附19例报道)[J]. 中国现代医学杂志, 2012, 22: 69-71. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXDY201235016.htm
    [11]
    Simon R. Complications After Pancreaticoduodenectomy[J]. Surg Clin North Am, 2021, 101: 865-874. DOI: 10.1016/j.suc.2021.06.011
    [12]
    Camilleri M, Chedid V, Ford AC, et al. Gastroparesis[J]. Nat Rev Dis Primers, 2018, 4: 41. DOI: 10.1038/s41572-018-0038-z
    [13]
    Hanna MM, Gadde R, Allen CJ, et al. Delayed gastric emptying after pancreaticoduodenectomy[J]. J Surg Res, 2016, 202: 380-388. DOI: 10.1016/j.jss.2015.12.053
    [14]
    Murakami H, Li S, Foreman R, et al. Intraoperative Vagus Nerve Stimulation Accelerates Postoperative Recovery in Rats[J]. J Gastrointest Surg, 2019, 23: 320-330. DOI: 10.1007/s11605-018-3969-5
    [15]
    李凯歌, 郭孟玮, 谭莉华, 等. 比较电针"大肠俞""天枢"穴对肠易激综合征模型大鼠内脏敏感性、Cajal间质细胞和辣椒素受体1的影响[J]. 中国针灸, 2018, 38: 625-629, 636. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE201806019.htm
    [16]
    张莘, 张选平, 杜玉茱, 等. 不同刺灸法对功能性便秘大鼠结肠组织肠神经相关蛋白表达的影响[J]. 针刺研究, 2017, 42: 407-412. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ201705006.htm
    [17]
    韩娟, 荣培晶, 王宏才, 等. 基于脑肠互动学说探析针刺治疗功能性消化不良[J]. 中医杂志, 2021, 62: 845-849. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202110005.htm
    [18]
    李怀玉, 陈云, 胡子毅, 等. 针灸治疗胃癌术后胃肠功能障碍疗效的Meta分析[J]. 中国针灸, 2022, 42: 595-602. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE202205028.htm
    [19]
    李成刚, 黄彬, 刘荣, 等. 针灸预防胰十二指肠切除术后胃排空延迟[J]. 解放军医学院学报, 2014, 35: 439-441. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJX201405013.htm
    [20]
    刘敬萱, 孙彦辉, 张莘, 等. 耳针理论学说的研究现状与思考[J]. 针刺研究, 2021, 46: 893-900. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ202110016.htm
    [21]
    Liu CH, Yang MH, Zhang GZ, et al. Neural networks and the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation in depression[J]. J Neuroinflammation, 2020, 17: 54.
    [22]
    Mao JJ, Liou KT, Baser RE, et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial[J]. JAMA Oncol, 2021, 7: 720-727.
    [23]
    葛曼, 黄晓桃, 向曦. 隐白穴艾灸合耳穴治疗对青春期异常子宫出血止血效应的影响[J]. 内蒙古中医药, 2022, 41: 99-100. https://www.cnki.com.cn/Article/CJFDTOTAL-NZYY202202057.htm
    [24]
    黄惠榕, 薛佳璐, 余真铃, 等. 耳穴贴压改善家兔腹部术后胃肠功能的作用机制研究[J]. 护理学杂志, 2022, 37: 43-45, 60. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202215012.htm
    [25]
    Bonaz B, Bazin T, Pellissier S. The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis[J]. Front Neurosci, 2018, 12: 49.
    [26]
    He W, Wang X, Shi H, et al. Auricular acupuncture and vagal regulation[J]. Evid Based Complement Alternat Med, 2012, 2012: 786839.
    [27]
    Lin S, Kajimura M, Takeuchi K, et al. Expression of muscarinic receptor subtypes in rat gastric smooth muscle: effect of M3 selective antagonist on gastric motility and emptying[J]. Dig Dis Sci, 1997, 42: 907-914.
    [28]
    Báez-Pagán CA, Delgado-Vélez M, Lasalde-Dominicci JA. Activation of the Macrophage α7 Nicotinic Acetylcholine Receptor and Control of Inflammation[J]. J Neuroimmune Pharmacol, 2015, 10: 468-476.
    [29]
    侯理伟, 荣培晶, 李亮, 等. 经皮耳穴迷走神经刺激对功能性消化不良大鼠自主神经功能的影响[J]. 针刺研究, 2021, 46: 663-670. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ202108006.htm
    [30]
    中华医学会麻醉学分会"穴位刺激围术期应用专家共识"工作小组. 穴位刺激围术期应用专家共识[J]. 中华麻醉学杂志, 2017, 37: 1153-1158.
    [31]
    季永荣, 梁仲惠. 胃及十二指肠疾病耳郭望诊与胃镜检查对比观察[J]. 中国针灸, 1995(15): 41-42. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZE505.031.htm
    [32]
    全国针刺麻醉学习班选编组. 针刺麻醉原理的探讨[M]. 北京: 人民卫生出版社, 1974: 364-366.
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