1
|
Gong CM, Huang HC, Liu JH, Yu SS, Chen YT. Auricular Acupressure Improve Constipation of Patients With Schizophrenia: A Pilot Randomized Controlled Study. Biol Res Nurs 2024; 26:418-428. [PMID: 38439651 DOI: 10.1177/10998004241236947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Background. Constipation is a common distressing problem in patients with schizophrenia that can cause complications and impair quality of life. Objective. The objective of this study was to investigate the efficacy of applying auricular acupressure (AA) treatment in improving constipation in patients with schizophrenia. Methods. A crossover randomized controlled trial design was performed from April 2022 to December 2023 at four psychiatric rehabilitation care centers. A total of 23 patients with schizophrenia received an AA intervention or usual care according to the designated treatment sequences. Measurements comprised subjective assessment of constipation by the Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire, an objective assessment of the stool pattern rated by a Bristol stool form scale, and heart rate variability. A generalized estimating equation model was used for data analyses. Results. After completing an 8-week AA intervention stimulating the Shenmen, San Jiao, Large intestine and Rectum, the AA group exhibited lower scores in the PAC-SYM total score (difference = -12.66, ,0.001), and the subscales: abdominal (difference = -3.36, p < .001), rectal (difference = -3.51, p < .001), and stool (difference = -5.79, p < .001), compared to those receiving usual care. The cases of constipation indicated by type 1 and type 2 of the BSF scale significantly decreased after the 8-week AA intervention. Moreover, the AA group displayed more parasympathetic dominance compared to the usual care group, with a low frequency to high frequency ratio of -1.15. Conclusion. AA is an effective non-pharmacological method for improving subjective constipation symptoms and objective stool pattern in patients with schizophrenia.
Collapse
Affiliation(s)
- Ciao-Min Gong
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ju-Han Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- School of Medicine, Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shiou-Shiun Yu
- Yilan Yuanshan Medical Foundation, Yilan Yuanshan Hospital, Yilan, Taiwan
| | - Yu-Ting Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Psychiatry, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| |
Collapse
|
2
|
Aminizadeh M, Tirgari B, Rashtabadi OR, Jahani Y, Tajadini H. Effectiveness of auricular acupressure on constipation and related quality of life among the older people in the residential care home: a randomized clinical trial. BMC Geriatr 2023; 23:171. [PMID: 36973676 PMCID: PMC10042113 DOI: 10.1186/s12877-023-03881-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION Constipation can be one of the biggest health problems for the older people that has negative effects on their quality of life. Some studies have reported that new non-pharmacological interventions such auricular acupressure have promising results in the management of constipation. This study was performed to investigate the effect of auricular acupressure on constipation and health-related quality of life in the older people living in the residential care home. METHODS Sample of this randomized clinical trial consisted of 53 older people with chronic constipation living in a residential care home in the southeast of Iran (Kerman city). The participants were randomly assigned to intervention (n = 27) and control (n = 26) groups. Auricular acupressure was applied to seven auricular acupoints (large intestine, rectum, San Jiao, spleen, lung, sympathetic, and subcortex) using Vaccaria seeds for the intervention group and for the control group, seedless auricular plasters were used at the seven auricular acupoints for 10 days. Data were collected before the intervention, end of the intervention, and 10-day follow-up using demographic and clinical, Patient Assessment of Constipation-Symptom, and Patient Assessment of Constipation-Quality of Life questionnaires. The SPSS-22 software was used for data analysis. RESULTS The difference between groups and times was significant in constipation and related quality of life and scores. The mean score of constipation at the end of intervention was 0.41 less in the intervention group than the control group (P < 0.0001). This mean score, in the intervention group also on the 10-day follow-up was 0.09 less than the control group (P = 0.004), which indicates a decrease in the severity of constipation symptoms. In the intervention group, mean score of quality of life related to constipation at the end of intervention and the 10-day follow-up was 0.56 and 0.19 less than the control group (Decrease in the mean score of quality of life related to constipation indicates an improvement in the quality of life) (P < 0.0001). CONCLUSION The results showed the positive effect of auricular acupressure on reducing the severity of constipation symptoms and improving the quality of life in old patients living in the residential care home. This non-pharmaceutical practice can be used by nurses as an inexpensive, safe, acceptable, and non-invasive nursing care for older people with constipation in homes, medical centers, or nursing homes.
Collapse
Affiliation(s)
- Mahdi Aminizadeh
- Department of Medical Surgical Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Batool Tirgari
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | | | - Yunes Jahani
- Modelling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Haleh Tajadini
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
3
|
Shi X, Hu Y, Zhang B, Li W, Chen JD, Liu F. Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation. JCI Insight 2021; 6:e150052. [PMID: 34138761 PMCID: PMC8410029 DOI: 10.1172/jci.insight.150052] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/16/2021] [Indexed: 12/28/2022] Open
Abstract
BackgroundAbdominal pain and constipation are 2 main symptoms in patients with constipation-predominant irritable bowel syndrome (IBS-C). This study aimed to investigate the effects and possible mechanisms of transcutaneous auricular vagal nerve stimulation (taVNS) in patients with IBS-C.MethodsForty-two patients with IBS-C were randomized into a 4-week sham-taVNS or taVNS treatment. The primary outcomes were complete spontaneous bowel movements per week (CSBMs/week) and visual analog scale (VAS) for abdominal pain. High-resolution anorectal manometry (HRAM) was performed to evaluate anorectal motor and sensory function. Cytokines and brain gut peptides were analyzed in blood samples. ECG was recorded for the assessment of autonomic function.ResultsCompared with sham-taVNS, (a) taVNS increased CSBMs/week (P = 0.001) and decreased VAS pain score (P = 0.001); (b) improved quality of life (P = 0.020) and decreased IBS symptom score (P = 0.001); (c) improved rectoanal inhibitory reflex (P = 0.014) and improved rectal sensation (P < 0.04); (d) decreased a number of proinflammatory cytokines and serotonin in circulation; and (e) enhanced vagal activity (P = 0.040). The vagal activity was weakly correlated with the CSBMs/week (r = 0.391; P = 0.010) and the VAS pain score (r = -0.347; P = 0.025).ConclusionsNoninvasive taVNS improves both constipation and abdominal pain in patients with IBS-C. The improvement in IBS-C symptoms might be attributed to the integrative effects of taVNS on intestinal functions mediated via the autoimmune mechanisms.Trial registrationwww.chictr.org.cn, no. ChiCTR2000029644.FundingNational Natural Science Foundation of China (grant no. 81970538 for FL).
Collapse
Affiliation(s)
- Xiaodan Shi
- Department of Gastroenterology, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - Yedong Hu
- Department of Gastroenterology, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - Bo Zhang
- Department of Gastroenterology, the 928th Hospital of the PLA Joint Logistics Support Force, Haikou, Hainan, China
| | - Wenna Li
- Department of Gastroenterology, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - Jiande Dz Chen
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Fei Liu
- Department of Gastroenterology, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| |
Collapse
|
4
|
Suen LKP, Yeh CH, Yeung SKW, Yeung JWF. Is the combined auriculotherapy approach superior to magneto-auriculotherapy alone in aging males with lower urinary tract symptoms? A randomized controlled trial. Aging Male 2020; 23:544-555. [PMID: 30651007 DOI: 10.1080/13685538.2018.1542673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The negative impact of lower urinary tract symptoms (LUTS) on affected males is substantial. This study aims to assess whether a combined auriculotherapy (AT) using laser AT (LAT) and magneto-AT (MAT) is more effective than using MAT alone or placebo for managing LUTS of aging males.Methods: A randomized controlled, double-blinded trial was conducted. Sixty-two aging males with moderate or severe LUTS symptoms were randomly allocated into groups: Group 1, placebo LAT plus placebo MAT (n = 20); Group 2, combined AT approach using LAT plus MAT (n = 20); and Group 3, placebo LAT followed by MAT (n = 22). Six ear acupoints assumed to be suitable for alleviating LUTS were used. The total treatment period was 4 weeks, with follow-up visits till 3 months. Generalized estimating equations model was used for the examination of the interactions among the groups over time.Results: A combined AT approach exhibited a stronger treatment effect in relieving voiding problems, improving the peak urinary flow rate, and reducing the post-void residual urine than the placebo group or MAT alone.Conclusions: This study demonstrates that the AT protocol used in this study for aging males with LUTS is feasible and can be adopted in future study of increased scale.
Collapse
Affiliation(s)
- Lorna K P Suen
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong
| | - Chao Hsing Yeh
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Simon K W Yeung
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong
| | - Jerry W F Yeung
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong
| |
Collapse
|
5
|
Wang X, Yang B, Yin J, Wei W, Chen JDZ. Electroacupuncture via chronically implanted electrodes improves gastrointestinal motility by balancing sympathovagal activities in a rat model of constipation. Am J Physiol Gastrointest Liver Physiol 2019; 316:G797-G805. [PMID: 30920306 DOI: 10.1152/ajpgi.00018.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Electroacupuncture (EA) has been reported for treating constipation in clinical studies. However, little is known of the possible mechanisms involved in the prokinetic effect of EA. The aim of this study was to investigate the effects and underlying autonomic mechanisms of EA via chronically implanted electrodes for constipation in rat induced by Loperamide (Lop). Lop was given to regular rats to induce constipation. EA was performed via a pair of electrodes chronically implanted at bilateral acupoint ST-36. Feces characteristics, gastric emptying, small intestinal transit, distal colon transit time (dCTT), and whole gut transit time (WGTT) were measured in various sessions with EA or sham EA in rats with constipation induced by Lop. Heart rate variability (HRV) derived from the electrocardiogram was analyzed to evaluate autonomic functions. The number of fecal pellets was reduced by 27% with Lop (P < 0.01) and normalized by 7-day EA. Similar results were also observed in pellet weight. In normal rats compared with sham EA, EA shortened dCTT by 74% (P < 0.05 vs. sham EA), increased small intestinal transit by 28% (P < 0.01) and gastric emptying by 27% (P < 0.05), and accelerated whole gut transit by 14% (P < 0.05). In Lop-treated rats, the dCTT and WGTT were prolonged by Lop and normalized by EA. Lop significantly decreased vagal activity and increased sympathetic nerve activity; however, EA reversed these effects. EA at ST-36 via chronically implanted electrodes improves Lop-induced constipation by enhancing GI motility via the autonomic mechanisms. NEW & NOTEWORTHY The findings of the present study suggest that the proposed electroacupuncture (EA) may have great therapeutic potential for treating patients with opioid-induced constipation. It was demonstrated that EA at ST-36 improved transit of every organ along the gut mediated via the autonomic mechanisms in normal rats and rats with Lop-induced constipation. It is advised to administrate EA daily instead of two or three times weekly as reported in most of the clinical studies.
Collapse
Affiliation(s)
- Xinjun Wang
- Division of Gastroenterology and Hepatology, Johns Hopkins University , Baltimore, Maryland.,Second School of Clinic Medicine, Nanjing University of Chinese Medicine , Nanjing, Jiangsu , China
| | - Boli Yang
- Department of Digestive Diseases, General Hospital of Jincheng Anthracite Mining Group, Jincheng, Shanxi , China
| | - Jieyun Yin
- Division of Gastroenterology and Hepatology, Johns Hopkins University , Baltimore, Maryland
| | - Wei Wei
- Division of Gastroenterology, Wangjing Hospital , Beijing , China
| | - Jiande D Z Chen
- Division of Gastroenterology and Hepatology, Johns Hopkins University , Baltimore, Maryland
| |
Collapse
|
6
|
Wang PM, Hsu CW, Liu CT, Lai TY, Tzeng FL, Huang CF. Effect of acupressure on constipation in patients with advanced cancer. Support Care Cancer 2019; 27:3473-3478. [PMID: 30675666 DOI: 10.1007/s00520-019-4655-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/16/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Constipation is a common and distressing symptom for patients with advanced cancer. Few reports have focused on the symptoms of constipation in patients with advanced cancer. The aim of this study was to investigate the effect of a short-term acupressure intervention on patients with advanced cancer. METHODS This study used a non-randomized, pre-post study design to assess the effect of acupressure intervention. A total of 30 patients with advanced cancer were recruited from the hospice unit of a medical center in southern Taiwan. In addition to routine care, patients in the intervention group received an 8-min acupressure treatment daily for 3 consecutive days. Three acupoints were used in this study: Zhongwan (CV12), Guanyuan (CV4), and Tianshu (ST25). Analysis of covariance was used to compare the differences in symptoms of constipation between the two groups, adjusted for baseline values. Effect sizes were calculated using partial eta squared (η2). RESULTS Significant improvements in symptoms of constipation (partial η2 = 0.40, p < 0.001 for straining during defecation; partial η2 = 0.30, p = 0.002 for hard stools; partial η2 = 0.42, p < 0.001 for sensation of incomplete evacuation; and partial η2 = 0.29, p = 0.002 for sensation of anorectal obstruction), Bristol stool form scale scores (partial η2 = 0.40, p < 0.001), comfort levels during defecation (partial η2 = 0.82, p < 0.001), and colonic motility (partial η2 = 0.85, p < 0.001) were observed in patients receiving acupressure intervention compared with the controls. CONCLUSIONS Findings from this study indicated that short-term acupressure was effective in alleviating symptoms of constipation among patients with advanced cancer. Further, randomized controlled trials are warranted to confirm the results.
Collapse
Affiliation(s)
- Pei-Ming Wang
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Road, Kaohsiung City, 83301, Taiwan
| | - Ching-Wen Hsu
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
| | - Chun-Ting Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
| | - Ting-Yu Lai
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
| | - Fe-Ling Tzeng
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
| | - Chih-Fang Huang
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Road, Kaohsiung City, 83301, Taiwan.
- Department of Long Term Care, Chung Hwa University of Medical Technology, Tainan City, Taiwan.
| |
Collapse
|
7
|
Zhou SL, Zhang XL, Wang JH. Comparison of Electroacupuncture and Medical Treatment for Functional Constipation: A Systematic Review and Meta-Analysis. Acupunct Med 2018. [PMID: 28630049 DOI: 10.1136/acupmed-2016-011127] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objectives To assess the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC). Design Systematic review and meta-analysis. Setting To be included, studies needed to: (1) have been randomised controlled trials; (2) have recruited adult patients diagnosed with FC according to the Rome II/III criteria or the American Gastroenterological Association guideline for chronic FC; and (3) have randomised patients to be treated with EA or anti-constipation medication. We searched Medline, the Cochrane Library and Embase databases for articles published up to 30 June 2016. Intervention EA or anti-constipation medication. Primary and secondary outcome measures The primary outcome was the change in the number of weekly spontaneous bowel movements. Secondary outcomes were total response rate (or total effective rate), symptom reduction and Cleveland Clinic constipation scores. Results The pooled results showed significantly more improvement in the frequency of spontaneous bowel movements in the EA treatment group compared with the medicine-treated group (pooled SMD 0.244, 95% CI 0.065 to 0.424, P=0.008). Deep-needling EA was significantly more effective than treatment with medication at increasing the frequency of spontaneous bowel movements (p=0.019). Significantly greater improvement was also seen for total response rates (p=0.018) and reductions in symptom score (p<0.001) in EA-treated patients. Conclusions EA was more effective than medication at improving spontaneous bowel movements and total response rate, and reducing the symptoms of FC.
Collapse
Affiliation(s)
- Sheng-Li Zhou
- General Medicine, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Xiu-Lai Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Jing-Hua Wang
- General Medicine, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| |
Collapse
|
8
|
Zhang T, Wang G, Li B, Wang L, Guo J, Hu J, Du X, Hong Q, Sun J, Liu C. Effect of acupuncture for constipation after ischemic stroke: study protocol for a randomized controlled trial. Trials 2018; 19:454. [PMID: 30134942 PMCID: PMC6106942 DOI: 10.1186/s13063-018-2750-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 06/19/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Constipation is a common complication after stroke that can severely influence a patient's quality of life and rehabilitation. Treatments for constipation after stroke vary. Acupuncture may improve spontaneous bowel movements, quality of life, and clinical symptoms. The study seeks to assess the preliminary effects of acupuncture on constipation after an ischemic stroke. METHODS/DESIGN This is a prospective randomized controlled pilot trial design in which 120 eligible patients will be randomly allocated to one of three groups. The acupuncture group (n = 40) will receive acupuncture and routine care, the medication group (n = 40) will receive mosapride citrate and routine care, and the control group (n = 40) will receive only routine care for ischemic stroke. Patients will be recruited 2 weeks to 6 months after stroke onset and will receive the intervention continuously over 4 weeks, with a follow-up period of 4 additional weeks. Adverse events will be recorded to assess the safety and tolerability of acupuncture for constipation after an ischemic stroke. The primary outcome will be the change in the weekly mean number of complete spontaneous bowel movements. Secondary outcomes will include any change in the weekly mean number of spontaneous bowel movements, mean stool consistency scores, mean straining scores during defecation, and frequency of laxative use. All outcome measures will be assessed at inception, after the intervention (4 weeks), and at the follow-up (8 weeks). DISCUSSION This study will provide evidence of the preliminary effects and inform future sample size calculations for studies of acupuncture for constipation following an ischemic stroke. These findings will inform subsequent large-scale randomized controlled trials. TRIAL REGISTRATION ISRCTN, 22214747 . Registered on 17 August 2015.
Collapse
Affiliation(s)
- Tao Zhang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Guiling Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Linpeng Wang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Jing Guo
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Junxia Hu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Xin Du
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Qiuyang Hong
- Department of Acupuncture and Moxibustion, Shunyi Hospital affiliated to Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Jingqing Sun
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China.
| | - Cunzhi Liu
- Dongfang Hospital affiliated to Beijing University of Traditional Chinese Medicine, Beijing, China.
| |
Collapse
|
9
|
Zheng H, Liu ZS, Zhang W, Chen M, Zhong F, Jing XH, Rong PJ, Zhu WZ, Wang FC, Liu ZB, Tang CZ, Wang SJ, Zhou MQ, Li Y, Zhu B. Acupuncture for patients with chronic functional constipation: A randomized controlled trial. Neurogastroenterol Motil 2018; 30:e13307. [PMID: 29392784 DOI: 10.1111/nmo.13307] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Acupuncture is used to treat chronic functional constipation (CFC) in China, despite limited evidence. We aim to assess the effectiveness and safety of acupuncture in managing CFC. METHODS A multicenter randomized controlled trial was performed involving 684 patients with CFC; the patients were randomly allocated to receive He acupuncture (n = 172), Shu-mu acupuncture (n = 171), He-shu-mu acupuncture (n = 171), or oral administration of mosapride (n = 170). Sixteen sessions of acupuncture were given in the treatment duration of 4 weeks. The primary outcome was the change in spontaneous bowel movements (SBMs) at week 4 (at the end of treatment) compared to baseline. The secondary outcomes included stool consistency (Bristol scale), the degree of straining during defecation, and adverse events. KEY RESULTS The SBMs increased in all the four groups at week 4, and the magnitude of increase was equivalent in the four groups (He acupuncture, 2.7 [95% CI, 2.3-3.1]; Shu-mu acupuncture, 2.7 [95% CI, 2.3-3.0]; He-shu-mu acupuncture, 2.2 [95% CI, 1.9-2.5]; and mosapride, 2.4 [95% CI, 2.0-2.9]; P = .226). However, the change in SBMs at week 8 was significantly smaller in mosapride group (1.4 [95% CI, 1.0-1.8]) than the three acupuncture groups (2.4 [95% CI, 2.1-2.7], 2.3 [95% CI, 1.9-2.7], 2.1 [95% CI, 1.7-2.5] in He, Shu-mu, and He-shu-mu group, respectively, P = .005). CONCLUSIONS & INTERFERENCES The three acupuncture treatments were as effective as mosapride in improving stool frequency and stool consistency in CFC, but the magnitude of the treatment effect is unknown due to the lack of sham acupuncture control.
Collapse
Affiliation(s)
- H Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Z-S Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - W Zhang
- The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China
| | - M Chen
- Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - F Zhong
- The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China
| | - X-H Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - P-J Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - W-Z Zhu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - F-C Wang
- Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Z-B Liu
- Shanxi University of Traditional Chinese Medicine, Xianyang, Shanxi, China
| | - C-Z Tang
- Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - S-J Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - M-Q Zhou
- Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China
| | - Y Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - B Zhu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
10
|
Sethi T. Constipation. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Auricular therapy for lactation: A systematic review. Complement Ther Clin Pract 2017; 29:169-184. [DOI: 10.1016/j.ctcp.2017.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/02/2017] [Accepted: 09/12/2017] [Indexed: 02/08/2023]
|
12
|
Chen H, Zhu W, Lu J, Fan J, Sun L, Feng X, Liu H, Zhang Z, Wang Y. The Effects of Auricular Electro-Acupuncture on Ameliorating the Dysfunction of Interstitial Cells of Cajal Networks and nNOSmRNA Expression in Antrum of STZ-Induced Diabetic Rats. PLoS One 2016; 11:e0166638. [PMID: 27930657 PMCID: PMC5145159 DOI: 10.1371/journal.pone.0166638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/01/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUD Interstitial cells of Cajal (ICCs) and nNOS play a crucial role in diabetic gastrointestinal dysmotility(DGD). Our previous study found that electro-acupuncture(EA) on ear point 'stomach' could repair the gastric dysrhythmias in rats induced by rectal distention(RD) after meal. However, little were known about the possible effect of auricular electro-acupuncture (AEA) on diabetic rats. Thus, we designed this study to investigate the effect of AEA on streptozotocin(STZ)-induced diabetic rats. METHOD Forty male Sprague_Dawley (SD) rats were injected with STZ, at the end of 8th week after injection, animals were randomly divided into four groups and received 2 weeks-treatment(10 times) respectively: control group(CON,n = 10, no stimulation), sham auricular electro-acupuncture group(SEA,n = 10, low frequency EA on earlobes), auricular eletro-acupuncture group(AEA,n = 10, low frequency EA on ear point 'stomach'), and ST-36 group(ST-36,n = 10, low frequency EA on ST-36). Gastrointestinal (GI) motility was measured by GI transit rate. ICCs(c-kit+ expression) in antrum were analyzed by Immunohistochemistry and western blotting. NO level in blood serum were detected by Griess Reagent, and nNOSmRNA expression in antrum were determined by Real-time PCR. RESULTS GI transit rate and ICCs(c-kit+ expression) in antrum of AEA group have the tendency to increase compared with CON group, but had no statistics difference (P>0.05). nNOSmRNA expression in antrum of AEA group was dramatically increased compared with CON group (P = 0.037). CONCLUSIONS Low frequency EA on ear 'stomach' point could significantly up-regulate nNOS mRNA expression and ameliorate the ICCs networks partly in gastric antrum of STZ -induced diabetic rats, which may has benefits on regulating the GI motility.
Collapse
Affiliation(s)
- Huan Chen
- Department of Acupuncture, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weijian Zhu
- Department of Acupuncture, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Lu
- Department of Acupuncture, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jinqing Fan
- Department of Acupuncture, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Luning Sun
- Department of Pharmacy, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoke Feng
- Department of Traditional Chinese Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hao Liu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhaohui Zhang
- Department of Acupuncture, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yongqing Wang
- Department of Pharmacy, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
13
|
LI HAIXIA, YIN JIEYUN, ZHANG ZHAOHUI, WINSTON JOHNH, SHI XUANZHENG, CHEN JIANDED. Auricular vagal nerve stimulation ameliorates burn-induced gastric dysmotility via sympathetic-COX-2 pathways in rats. Neurogastroenterol Motil 2016; 28:36-42. [PMID: 26486522 PMCID: PMC4688125 DOI: 10.1111/nmo.12693] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/29/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Severe burn injury has been demonstrated to delay gastric emptying. The aim of this study was to investigate effects and cellular mechanisms of auricular electroacupuncture (AEA) at the acupoints innervated by the auricular branch of vagus nerve on burn-induced gastric dysmotility in rats. METHODS Propranolol (β-adrenoceptor antagonist) was injected intraperitoneally after the rats underwent burn injury. All experiments were performed 6 h following burn/sham burn injury. AEA was performed at bilateral auricular acupoints for 45 min. Electrocardiogram was recorded for 30 min. Plasma hormones were measured; cyclooxygenase (COX)-2 expressions in gastric tissue were measured using western blotting and real-time RT-PCR. KEY RESULTS (i) Burn injury delayed gastric emptying (p = 0.006) and AEA increased gastric emptying by 49% (p = 0.045). (ii) Burn injury evoked a significant elevation in plasma noradrenaline, which was suppressed by AEA. (iii) Burn injury significantly increased protein and mRNA expressions of COX-2 in gastric fundus and antrum. AEA suppressed burn-induced increase in protein expressions, but not mRNA expressions of COX-2. CONCLUSIONS & INFERENCES Burn injury delays gastric emptying by up-regulating COX-2 attributed to sympathetic overactivity. AEA improves burn-induced delay in gastric emptying, possibly mediated via the sympathetic-COX-2 pathway.
Collapse
Affiliation(s)
- HAIXIA LI
- Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch at Galveston, Texas,Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - JIEYUN YIN
- Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch at Galveston, Texas,Division of Gastroenterology and Hepatology, Johns Hopkins School of Medicine, Baltimore, MD 21224
| | - ZHAOHUI ZHANG
- Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch at Galveston, Texas
| | - JOHN H. WINSTON
- Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch at Galveston, Texas
| | - XUAN-ZHENG SHI
- Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch at Galveston, Texas
| | - JIANDE D.Z. CHEN
- Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch at Galveston, Texas,Division of Gastroenterology and Hepatology, Johns Hopkins School of Medicine, Baltimore, MD 21224
| |
Collapse
|
14
|
Wong WK, Chien WT, Lee WM. Self-administered acupressure for treating adult psychiatric patients with constipation: a randomized controlled trial. Chin Med 2015; 10:32. [PMID: 26535053 PMCID: PMC4630845 DOI: 10.1186/s13020-015-0064-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 10/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Constipation has a high prevalence rate (>30 %) in psychiatric patients with psychotropic drugs. Common pharmacological and non-pharmacological interventions for constipation might have longer-term negative and adverse effects that would outweigh their short-term efficacy in symptom reduction. This randomized controlled trial aims to investigate the effect of self-administered acupressure for the management of constipation, in hospitalized psychiatric patients. METHODS Seventy-eight patients were recruited in matched pairs in terms of gender, age and laxative use from five acute psychiatric wards in Hong Kong. Each of these matched pairs of patients was randomly assigned to either a self-administered acupressure (n = 39) or a sham group (n = 39), using computer-generated random numbers. After baseline measurement, the intervention and sham group received the same training in self-administered acupressure and supervised practice once per day for 10 days, except light pressure on non-acupoints was taught to the sham group. The acupoints chosen for acupressure included Zhongwan (RN12), right and left Tianshu (ST25), right and left Quchi (LI11). Participants' symptoms and quality of life regarding constipation were measured at baseline and immediately and 2 weeks after completion of the interventions with constipation assessment scale and patient assessment of constipation quality of life questionnaire, respectively. RESULTS After 2 weeks follow-up, participants who had received self-administered acupressure indicated significantly greater improvements in both symptom severity (P = 0.0003) and quality of life (P = 0.0004) when compared with the sham group. CONCLUSION The psychiatric patients with constipation who practiced self-administered acupressure for 10 days improved their symptom severity and perceived quality of life immediately and 2 weeks after completion of the intervention in comparison with the sham group. TRIAL REGISTRATION The trial was registered with the ClinicalTrials.gov (Reg. No: NCT02187640).
Collapse
Affiliation(s)
- Wai Kit Wong
- />School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wai Tong Chien
- />School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wai Ming Lee
- />Forensic Community Psychiatric Nursing Team, Castle Peak Hospital, Tuen Mun, Hong Kong
| |
Collapse
|
15
|
Zheng Q, Zheng H, Lu L, Leng J, Zhou S, Zheng H, Huang W, Liu Z, Zhu B, Li Y. Acupuncture for functional constipation: protocol of an individual patient data meta-analysis. BMJ Open 2015; 5:e007137. [PMID: 25986636 PMCID: PMC4442149 DOI: 10.1136/bmjopen-2014-007137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Functional constipation (FC) is a common gastrointestinal disease. Systematic reviews indicate that acupuncture may be effective for patients with FC. However, this conclusion is not convincing due to the quality, sample size and methodological heterogeneity of the studies included by these systematic reviews. Therefore, it is necessary for us to conduct a meta-analysis of individual patient data (IPD) from high-quality clinical trials to determine whether acupuncture is effective for patients with FC. METHODS AND ANALYSIS Randomised controlled trials (RCTs) of acupuncture for adult patients with FC will be searched in several databases from inception to April 2015. The corresponding authors of eligible studies will be contacted and invited to contribute raw data. The primary outcome is the change in spontaneous defaecation per week from baseline. The secondary outcomes include the proportion of responders, changes in stool quality, mean transit time, proportion of patients using laxatives and adverse events. We will check all of the data and perform reanalysis according to the statistical methodology reported in previous publications. Then we will harmonise the raw data and use a two-step method to conduct the IPD meta-analysis. First, we will calculate the effect size of acupuncture of each trial by analysis of covariance, with the principal end point as the dependent variable and the baseline scores as the covariates. Second, the effect size of acupuncture in each original study will be combined in the meta-analysis. DISSEMINATION On the basis of the IPD meta-analysis of high-quality RCTs, this review will answer the question of whether acupuncture is effective for FC. The findings of the review will be disseminated through peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER PROSPERO 2014 CRD42014009901.
Collapse
Affiliation(s)
- Qianhua Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Hui Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Lingyun Lu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Jincheng Leng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Siyuan Zhou
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Huabin Zheng
- First Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Wenjing Huang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité, University Medical Center, Berlin, Germany
| | - Zhishun Liu
- China Academy of Chinese Medical Sciences, Guang'anmen Hospital, Beijing, People's Republic of China
| | - Bing Zhu
- China Academy of Chinese Medical Sciences, Beijing, People's Republic of China
| | - Ying Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| |
Collapse
|
16
|
Complementary and Alternative Therapies for Chronic Constipation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:396396. [PMID: 26064163 PMCID: PMC4433664 DOI: 10.1155/2015/396396] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 01/08/2015] [Indexed: 02/08/2023]
Abstract
Chronic constipation, an ancient disease, is prevalent, and costly in the general population. Complementary and alternative therapies are frequently used for constipation. This review introduces various methods of complementary and alternative therapies, including acupuncture, moxibustion, massage, and herbal medicine. Efficacy, safety, influence factors, sham control design, and mechanisms of these therapies are discussed and evaluated. Acupuncture or electroacupuncture was found to be most commonly used for constipation among these complementary and alternative therapies, followed by herbal medicine. Although only a small number of clinical studies are flawless, our review of the literature seems to suggest that acupuncture or electroacupuncture and herbal medicine are effective in treating constipation, whereas findings on massage and moxibustion are inconclusive. More well-designed clinical trials are needed to improve and prove the efficacy of the complementary and alternative therapies for constipation; mechanistic studies that would lead to wide spread use and improvement of the methods are also discussed in this review.
Collapse
|
17
|
Ameliorating effects of auricular electroacupuncture on rectal distention-induced gastric dysrhythmias in rats. PLoS One 2015; 10:e0114226. [PMID: 25643282 PMCID: PMC4313944 DOI: 10.1371/journal.pone.0114226] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 11/04/2014] [Indexed: 12/12/2022] Open
Abstract
Gastric slow waves (GSW) are known to regulate gastric motility and are impaired with rectal distention (RD). Electroacupuncture (EA) at body acupoints, such as ST 36, has been shown to improve gastric dysrhythmias; however, little is known about the possible effects of auricular electroacupuncture (AEA) on GSW. To study effects and possible mechanisms of AEA on RD-induced gastric dysrhythmias in rats, ten male Sprague-Dawley (SD) rats implanted with gastric serosal electrodes were studied in two different experiments in fed state. Four sessions were performed in experiment 1 as follows: control (RD, no stimulation), RD+AEA, RD+EA at body points and RD+sham AEA. Two sessions were included in experiment 2 to study mechanisms of AEA: RD + atropine and RD + atropine + AEA. It was found that 1) RD significantly decreased the percentage of normal GSW from 89.8 ± 3.5% to 76.0 ± 3.3% (P<0.05); 2) AEA increased the percentage of normal GSW during RD to 94.0 ± 2.1% (P<0.05 vs. RD) via a reduction in the percentages of tachygastria and arrhythmia (P<0.05 vs. RD); 3) atropine blocked the ameliorating effect of AEA on RD-induced gastric dysrhythmias. Our results demonstrated that RD induces gastric dysrhythmias in fed state in rats. AEA improves RD-induced gastric dysrhythmias via the vagal pathway. AEA may have a therapeutic potential in treating gastric dysrhythmias.
Collapse
|
18
|
Yang LH, Duan PB, Du SZ, Sun JF, Mei SJ, Wang XQ, Zhang YY. Efficacy of auriculotherapy for constipation in adults: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med 2014; 20:590-605. [PMID: 25020089 PMCID: PMC4129665 DOI: 10.1089/acm.2013.0324] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess the clinical evidence of auriculotherapy for constipation treatment and to identify the efficacy of groups using Semen vaccariae or magnetic pellets as taped objects in managing constipation. METHODS Databases were searched, including five English-language databases (the Cochrane Library, PubMed, Embase, CINAHL, and AMED) and four Chinese medical databases. Only randomized controlled trials were included in the review process. Critical appraisal was conducted using the Cochrane risk of bias tool. RESULTS Seventeen randomized, controlled trials (RCTs) met the inclusion criteria, of which 2 had low risk of bias. The primary outcome measures were the improvement rate and total effective rate. A meta-analysis of 15 RCTs showed a moderate, significant effect of auriculotherapy in managing constipation compared with controls (relative risk [RR], 2.06; 95% confidence interval [CI], 1.52- 2.79; p<0.00001). The 15 RCTs also showed a moderate, significant effect of auriculotherapy in relieving constipation (RR, 1.28; 95% CI, 1.13-1.44; p<0.0001). For other symptoms associated with constipation, such as abdominal distension or anorexia, results of the meta-analyses showed no statistical significance. Subgroup analysis revealed that use of S. vaccariae and use of magnetic pellets were both statistically favored over the control in relieving constipation. CONCLUSIONS Current evidence illustrated that auriculotherapy, a relatively safe strategy, is probably beneficial in managing constipation. However, most of the eligible RCTs had a high risk of bias, and all were conducted in China. No definitive conclusion can be made because of cultural and geographic differences. Further rigorous RCTs from around the world are warranted to confirm the effect and safety of auriculotherapy for constipation.
Collapse
Affiliation(s)
- Li-Hua Yang
- Department of Oncology, Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Pei-Bei Duan
- Department of Nursing, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Shi-Zheng Du
- Department of Oncology, Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Jin-Fang Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Si-Juan Mei
- Department of Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Xiao-Qing Wang
- Department of Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Yuan-Yuan Zhang
- Department of Orthopedics, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| |
Collapse
|
19
|
Li MK, Lee TFD, Suen KPL. Complementary effects of auricular acupressure in relieving constipation symptoms and promoting disease-specific health-related quality of life: A randomized placebo-controlled trial. Complement Ther Med 2014; 22:266-77. [PMID: 24731898 DOI: 10.1016/j.ctim.2014.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 10/23/2013] [Accepted: 01/30/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Constipation has been identified as a worldwide health problem among elderly people. Currently, it is not effectively relieved by the use of laxatives and lifestyle modification. Previous studies reported promising results in managing constipation with auricular acupressure (AA), although its effectiveness was not affirmed. This study is to evaluate the complementary effects of AA in relieving constipation symptoms and in promoting disease-specific health-related quality of life (HRQOL) among elderly residential care home (RCH) residents in Hong Kong. DESIGN Randomized placebo-controlled trial. SETTING Elderly RCH. INTERVENTION Ninety-nine participants were randomly assigned to either experimental group (AA using auricular plasters with magnetic pellets), placebo-controlled group (AA using auricular plasters with Semen Vaccariae), or usual care group (AA using auricular plasters only). AA was applied onto seven auricular acupoints for 10 days. MAIN OUTCOME MEASURES Constipation symptoms and disease-specific HRQOL were measured before AA, at the completion of AA (D10), and at the 10th-day follow-up time (D20). RESULTS Significant group×time interaction effect was found in the change of satisfaction subscale between the experimental group and placebo-controlled group at D10 (p=0.016) and D20 (p=0.016) relative to the baselines. For both constipation symptoms and disease-specific HRQOL, the experimental group demonstrated the greatest improvement after receiving AA at both D10 and D20 compared with the other two groups. CONCLUSION The current findings indicated positive clinical value of AA with magnetic pellets in managing constipation in elderly RCH residents. AA was also found to be a safe and acceptable intervention.
Collapse
Affiliation(s)
- M K Li
- Division of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong.
| | - T F Diana Lee
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
| | - K P Lorna Suen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| |
Collapse
|
20
|
Zhang T, Chon TY, Liu B, Do A, Li G, Bauer B, Wang L, Liu Z. Efficacy of acupuncture for chronic constipation: a systematic review. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2013; 41:717-42. [PMID: 23895148 DOI: 10.1142/s0192415x13500493] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study was to evaluate the efficacy and safety of acupuncture for chronic functional constipation. Randomized controlled trials were searched in several databases. The primary outcome was a change in the number of weekly spontaneous bowel movements. The secondary outcomes included colonic transit activity, effective rate, Cleveland Clinic Score, and health-related quality of life score. Meta-analysis was done by using RevMan 5.1. After strict screening, 15 RCTs were included, containing 1256 participants. All of them were conducted in China and published in Chinese journals. Meta-analysis indicated that acupuncture for chronic functional constipation was probably as effective as conventional medical therapy in the change of bowel movements. For the colonic transit activity, acupuncture might be the same as conventional medical therapy and could be better than sham acupuncture. For the Cleveland Clinic Score, acupuncture was unlikely inferior to conventional medical therapy and the deep acupuncture was better than normal depth acupuncture in abdominal region. No obvious adverse event was associated with acupuncture for constipation. In conclusion, acupuncture for chronic functional constipation is safe and may improve weekly spontaneous bowel movements, quality of life, and relevant symptoms. However, the evidence was limited by the small sample size and the methodological quality.
Collapse
Affiliation(s)
- Tao Zhang
- Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Cherniack EP. Use of complementary and alternative medicine to treat constipation in the elderly. Geriatr Gerontol Int 2013; 13:533-8. [PMID: 23294466 DOI: 10.1111/ggi.12023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2012] [Indexed: 01/14/2023]
Abstract
Many modalities of complementary and alternative medicine, such as probiotic bacteria, traditional herbal medicines, biofeedback and massage, have been used to treat constipation in older adults. Virtually all studies in the published literature have been plagued with methodological problems, such as lack of blinding. Chinese herbal medications have been the most frequent subject of studies in controlled trials, but have suffered from methodological insufficiencies, and few have been published in publications other than Chinese language journals. Several therapies, such as yogurt containing probiotic bacteria and massage, are relatively easy to use by the patient, and are likely to cause few adverse reactions. Therefore, complementary and alternative therapies might show the greatest promise for being adopted as adjunctive therapies to conventional treatment.
Collapse
Affiliation(s)
- E Paul Cherniack
- Geriatrics Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
22
|
The Effect of a Sweet Potato, Footbath, and Acupressure Intervention in Preventing Constipation in Hospitalized Patients With Acute Coronary Syndromes. Gastroenterol Nurs 2012; 35:271-7. [DOI: 10.1097/sga.0b013e31825ed7bc] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
|
23
|
Sethi T. Constipation. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
24
|
Lee MS, Choi TY, Park JE, Ernst E. Effects of moxibustion for constipation treatment: a systematic review of randomized controlled trials. Chin Med 2010; 5:28. [PMID: 20687948 PMCID: PMC2922210 DOI: 10.1186/1749-8546-5-28] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 08/05/2010] [Indexed: 11/10/2022] Open
Abstract
Several studies reported that moxibustion was effective in treating constipation. This systematic review assesses the clinical evidence for or against moxibustion for treating constipation. Twelve databases were searched from their inception to March 2010. Only randomized clinical trials (RCTs) were included if they compared moxibustion with placebo, sham treatment, drug therapy or no treatment. The methodological quality of these RCTs was assessed with the Cochrane risk of bias analysis. All three RCTs included in the study had a high risk of bias. Two included studies found favorable effects of moxibustion. The third RCT showed significant effects in the moxibustion group. Given that the methodological quality of all RCTs was poor, the results from the present review are insufficient to suggest that moxibustion is an effective treatment for constipation. More rigorous studies are warranted.
Collapse
Affiliation(s)
- Myeong Soo Lee
- Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon 305-811, South Korea.
| | | | | | | |
Collapse
|