Transcutaneous electrical acupoint stimulation combined with electroacupuncture promotes rapid recovery after abdominal surgery: Study protocol for a randomized controlled trial

Retrospective analysis on Lou Bei Er Chen decoction and acupuncture in gastroesophageal reflux disease post-gastric cancer surgery

BACKGROUND

Gastric cancer is a growing clinical challenge, particularly due to the increased risk of postoperative gastroesophageal reflux disease (GERD) following surgical treatment. traditional Chinese medicine (TCM), including acupuncture and herbal medicine, has been proposed as an adjunctive therapy to promote gastrointestinal recovery and alleviate GERD symptoms.

AIM

To retrospectively study the clinical efficacy of modified Lou Bei Er Chen decoction combined with acupuncture in treating patients with GERD after radical gastrectomy due to gastric cancer.

METHODS

A retrospective study was conducted, including patients with gastric cancer or malignant tumors of the stomach from January 2019 to December 2023 in the Affiliated Taizhou People's Hospital of Nanjing Medical University. Patients with a TCM diagnosis of qi depression and phlegm obstruction (n = 128) were selected on the basis of prescription and treatment principles. They were then divided into a control group (n = 61) and an observation group (n = 67). The control group received treatment with Western medicine domperidone. The observation group were treated with Lou Bei Er Chen decoction orally, with acupuncture at specific acupoints (bilateral Hegu, bilateral Neiguan, and bilateral Zusanli), in addition to the treatment as in the control group, for a continuous treatment period of 8 weeks. The improvement time of postoperative gastrointestinal function indicators, gastrointestinal dysfunction scores, GERD-Q scores, and TCM syndrome scores were further observed for both groups.

RESULTS

The observation group showed significantly shorter times for first flatus, defecation, bowel sound recovery, and initiation of nasogastric enteral nutrition than the control group (P < 0.05). Upon treatment, the two groups demonstrated a significant reduction in gastrointestinal dysfunction scores, with a more significant reduction in the observation group (P < 0.001). The GERD-Q scores significantly decreased after 8 weeks of treatment in the two groups (P < 0.05), with a significant reduction in the observation group (P < 0.05), compared with baseline. The TCM syndrome scores significantly decreased after 4 and 8 weeks of treatment in the two groups (P < 0.05), with a significant reduction in the observation group (P < 0.05). The effective rate of the observation group after 8 weeks of treatment was significantly higher than that after 4 weeks (χ 2 = 13.648, P = 0.003), and it was significantly higher than that of control group (χ 2 = 13.879, P = 0.003).

CONCLUSION

Lou Bei Er Chen decoction combined with acupuncture treatment can effectively alleviate clinical symptoms in patients GERD after gastric cancer surgery and improve their life quality. It is worthy of further promotion and application.

Research on the mechanism of core acupoints in electroacupuncture for functional constipation based on data mining and network acupuncture

Aim

Functional Constipation (FC) is a common gastrointestinal disorder that imposes a considerable strain on global health. It negatively impacts the quality of life and results in significant healthcare expenditures. Current treatments, such as lifestyle changes and medications, fail to meet patient satisfaction due to efficacy and safety issues. Electroacupuncture (EA), with its precise stimulation control and standardized protocols, shows promise in FC management. However, optimal EA parameters for FC treatment are yet to be established. Our study reviews EA applications in FC to inform a standardized treatment approach and explore EA's therapeutic mechanisms.

Methods

This comprehensive study utilized research literature from databases including PubMed, Embase, OVID, Web of Science, the Cochrane Library, CNKI, VIP, and Wanfang to perform a descriptive analysis of acupoint selection and EA parameters. It proceeded to analyze high-frequency acupoint groupings and stimulus parameters, followed by the excavation and analysis of core acupoint prescriptions. Subsequent steps integrated potential target identification for these core formulas, the assembly of a "core acupoint-prescription-target-constipation" network, and the construction of a protein-protein interaction (PPI) network to extract central targets. Additionally, Gene Ontology (GO) and KEGG enrichment analyses were conducted to prognosticate the underlying mechanisms by which EA may exert its therapeutic effects on FC.

Results

In our study, we analyzed 141EA prescriptions for FC and identified a core set of acupoints including Tianshu (ST25), Fujie (SP14), Shangjuxu (ST37), and Zusanli (ST36) through data mining. The frequency of use was highest for Tianshu (ST25) with 119 occurrences, followed by Fujie (SP14) with 59, Shangjuxu (ST37) with 42, and Zusanli (ST36) with 23. PPI network analysis revealed key targets such as NFKB1, IL6, MyD88, TLR4, TNF, TLR2, and IL1B. GO and KEGG analyses of 49 constipation-associated targets identified 257 BP, 37 CC, and 41 MF terms, and 154 significant pathways, with the top 20 visualized for further analysis.

Conclusion

The core acupoint prescription of EA for FC can exert its therapeutic effects by acting on multiple targets and pathways synergistically especially on NFKB1, IL6, MyD88, TLR4, TNF, TLR2, and IL1B. The research findings have preliminarily validated the fundamental effects and related mechanisms of EA parameters and core prescriptions, providing direction for further in-depth exploration of the mechanisms of action.

Advancements in the study of acute lung injury resulting from intestinal ischemia/reperfusion

Intestinal ischemia/reperfusion is a prevalent pathological process that can result in intestinal dysfunction, bacterial translocation, energy metabolism disturbances, and subsequent harm to distal tissues and organs via the circulatory system. Acute lung injury frequently arises as a complication of intestinal ischemia/reperfusion, exhibiting early onset and a grim prognosis. Without appropriate preventative measures and efficacious interventions, this condition may progress to acute respiratory distress syndrome and elevate mortality rates. Nonetheless, the precise mechanisms and efficacious treatments remain elusive. This paper synthesizes recent research models and pertinent injury evaluation criteria within the realm of acute lung injury induced by intestinal ischemia/reperfusion. The objective is to investigate the roles of pathophysiological mechanisms like oxidative stress, inflammatory response, apoptosis, ferroptosis, and pyroptosis; and to assess the strengths and limitations of current therapeutic approaches for acute lung injury stemming from intestinal ischemia/reperfusion. The goal is to elucidate potential targets for enhancing recovery rates, identify suitable treatment modalities, and offer insights for translating fundamental research into clinical applications.

Transcutaneous electrical acupoint stimulation for rehabilitation after total knee arthroplasty: a systematic review and meta-analysis

BACKGROUND

Rehabilitation after total knee arthroplasty (TKA) has become an indispensable part of the treatment strategy for degenerative joint disease. Despite some current research demonstrating efficacy of transcutaneous electrical acupoint stimulation (TEAS) for post-TKA rehabilitation, the evidence is not conclusive.

OBJECTIVE

To systematically assess the evidence supporting TEAS for rehabilitation after TKA.

METHODS

A literature search of the PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang, and Chinese Scientific Journal Data databases for relevant studies published up to October 16, 2023, was performed. Main indicators included visual analog scale (VAS) and functional scores; secondary indicators included range of motion (ROM), interleukin-6 (IL-6) and C-reactive protein (CRP) levels, and analgesia-related adverse events. Risk of bias was evaluated using the Cochrane Tool, and meta-analysis was performed using Review Manager version 5.4.

RESULTS

Twenty RCTs with 1295 participants were included. TEAS improved several outcomes compared to control groups. The TEAS group had significantly greater pain reduction at postoperative 6 h, 12 h, 24 h, 48 h, 72 h, 7 days, and 14 days. Moreover, TEAS significantly improved the Hospital for Special Surgery Knee Score, Knee Society Score, and ROM. Patients who underwent TEAS exhibited a lower incidence of analgesia-related adverse events and lower IL-6 and CRP levels.

CONCLUSIONS

Available evidence indicates that the application of TEAS in patients undergoing TKA is related to postoperative pain alleviation, functional improvement, and fewer adverse events associated with analgesia.

Efficacy of acupoint injection of metoclopramide for post-chemotherapy vomiting: A systematic review and meta-analysis

BACKGROUND

Vomiting is one of the most common adverse events of chemotherapy. The purpose of this study was to systematically review the clinical efficacy of acupoint injection of metoclopramide in the treatment of post-chemotherapy vomiting.

METHODS

We searched 4 general English databases and 4 conventional Chinese databases, all with a time frame from database creation to December 2022. The retrieved clinical trials of acupoint injection of metoclopramide for post-chemotherapy vomiting were then subjected to meta-analysis and trial sequential analysis.

RESULTS

A total of 12 studies were included, with a total sample size of 965 cases. Meta-analysis showed that acupoint injection of metoclopramide was effective in improving anti-vomiting effective rate [odds ratio = 5.67, 95% confidence interval = (3.80,8.47), P < .00001] compared with intramuscular/intravenous injection, and trial sequential analysis showed that this benefit was conclusive. Subgroup analysis demonstrated that acupoint injection significantly improved the anti-vomiting effective rate at doses of 10 mg qd, 20 mg qd, and 30 mg qd, as well as at durations of 1 day and 5 days. Subgroup analysis also indicated that injection at the Zusanli acupoint significantly increased the anti-vomiting effective rate, while injection at the Neiguan acupoint had an anti-vomiting effective rate comparable to that of the control group. Harbord regression showed no significant publication bias (P = .730).

CONCLUSION

Acupoint injection of metoclopramide for post-chemotherapy vomiting is more effective than intramuscular and intravenous injections and is not limited by dose or duration of treatment, which may be the preferred way of administration.

Transcutaneous electrical acupoint stimulation for prevention of postoperative urinary retention: A systematic review

Introduction

Transcutaneous electrical acupoint stimulation (TEAS) has been proposed for postoperative urinary retention (POUR). This meta-analysis evaluated the effect of TEAS in preventing POUR.

Methods

Databases were searched until February 6, 2023. Randomized controlled trials (RCTs) about TEAS for preventing POUR were included. The primary concern was the incidence of POUR, with post-void residual urine volume as a secondary outcome.

Results

Fourteen studies with 2865 participants were identified. TEAS reduced the incidence of POUR (RR = 0.44, 95%CI = 0.33 to 0.58, P < 0.00001) and decreased the post-void residual urine volume (MD = -75.41 mL, 95%CI = -118.76 to -32.06, P = 0.0007). The preventive effect on POUR was found in patients receiving anorectal, gynecologic, orthopedic and biliary surgery, but not urinary surgery. Dilatational- and continuous-wave TEAS had a great outcome in preventing POUR. Intraoperative TEAS, preoperative and intraoperative TEAS, and postoperative TEAS were beneficial, and TEAS was more beneficial when compared with sham TEAS and blank control. It is nevertheless difficult to rule out publication bias.

Conclusions

TEAS could prevent POUR. Due to insufficient evidence, multicenter, large-sample and high-quality RCTs should be conducted. (Registration:INPLASY202320095).