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In Taiwan, the number of patients who underwent abdominal surgery that attributed to gastrointestinal diseases, gynecological diseases, and cancer is increasing. Practically, some of the patients have unsatisfactory response to conventional medical treatment, which result in abnormal gastrointestinal function, prolonged bedtime, and increased hospital stay, as well as an increased risk of infection. Therefore, search for an effective and safe treatment that could be integrated to current medical treatment is of importance in the care of such patients.
Being with a long period of clinical experience and evidence-based curative effect, acupuncture could be applied as an adjunctive treatment for the complications of abdominal surgery. Currently, this patient-centered, pragmatic clinical trial compares the efficacy of using conventional medication alone and a combination of electroacupuncture and conventional drugs. The aim of this study is trying to explore acceptable and beneficial strategy to reduce the clinical symptoms, to improve quality of life, and decrease medical expenses.
A total of 80 volunteers of patients underwent abdominal surgery will be recruited from the intensive care unit of China Medical University Hospital. After diagnosis by surgeon, these patients will be assigned to receive the conventional drug alone or the conventional drug combined electroacupuncture treatment. All participants receive intravenous injection the conventional drug, Metoclopramide, every 12 hours in the trial. Electroacupuncture, twice daily for three days, is administered 48-72 hours after abdominal surgery. Visual analogue scale, feeding volume, gastric residual volume and assessment of adverse events will be done for every visit. Laboratory biochemistry analysis and other assessments including Visual Analogue Scale, Acute Physiology and Chronic Health Evaluation II score, and Sequential Organ Failure Assessment score will be completed at baseline and the end of intervention(3 days after initation of the intervention). Physiological and operative severity scores for the enumeration of mortality and morbidity (POSSUM) score will be done at the baseline. Instrumental examinations including heart rate variability and traditional Chinese medicine four examinations will be given before and after intervention. We expect that the efficacy of combined electroacupuncture with conventional drug is superior to conventional drug only in alleviation of gastrointestinal distension or/and improvement of motility in patients who underwent abdominal surgery. Moreover, we will further speculate the mechanism by analyzing laboratory data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Electroacupuncture combined with conventional drug therapy | Experimental | Conventional drug therapy: All participants receive intravenous infusion of metoclopramide(10mg) every 12 hours in the trial For participants with abdominal distension: Electroacupuncture will be applied to the acupoints (LI4, PC6, ST36, SP6) 30min For participants with post-operative ileus: Electroacupuncture will be applied to the acupoints (LI4, SJ6, ST36, ST37) 30min 32# acupuncture needle used and twice daily for three days |
|
| Conventional drug therapy | Active Comparator | Conventional drug therapy: All participants receive intravenous infusion of metoclopramide(10mg) every 12 hours in the trial |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electroacupuncture | Device | Experimental: Electroacupuncture combined with conventional drug therapy Conventional drug therapy: All participants receive intravenous infusion of metoclopramide(10mg) every 12 hours in the trial For participants with abdominal distension: Electroacupuncture will be applied to the acupoints (LI4, PC6, ST36, SP6) 30min For participants with post-operative ileus: Electroacupuncture will be applied to the acupoints (LI4, SJ6, ST36, ST37) 30min 32# acupuncture needle used and twice daily for three days |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analogue Scale | Changes from baseline to 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention | baseline, 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention |
| Daily feeding volume | Changes from baseline to 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention | baseline, 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention |
| Gastric residual volume | Changes from baseline to 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention | baseline, 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Acute Physiology and Chronic Health Evaluation II score | Changes from baseline to 3rd day of the intervention | baseline, Day 3 of the intervention |
| Sequential Organ Failure Assessment score | Changes from baseline to 3rd day of the intervention |
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Inclusion Criteria:
more than 20 years old.
Underwent abdominal surgery within one month
Meet one or both of the following indications
Had signed the informed consent with fully understand the aim of the clinical trial
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ming-Cheng Huang, M.D. | Contact | +886-4-22052121 | 4561 | mchuang1128@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Ming-Cheng Huang, M.D. | China Medical University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| China Medical University Hospital | Recruiting | Taichung | Taiwan |
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| ID | Term |
|---|---|
| D015671 | Electroacupuncture |
| ID | Term |
|---|---|
| D003131 | Combined Modality Therapy |
| D013812 | Therapeutics |
| D015670 | Acupuncture Therapy |
| D000529 | Complementary Therapies |
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|
| Conventional drug therapy | Drug | Conventional drug therapy: All participants receive intravenous infusion of metoclopramide(10mg) every 12 hours in the trial |
|
| baseline, Day 3 of the intervention |
| Physiological and operative severity scores for the enumeration of mortality and morbidity score | To predict morbidity and mortality of the patients in ICU | baseline |
| Blood examination | Changes of CBC, ALT, AST, BUN, Creatinine, CRP from baseline to 3rd day of the intervention | baseline, Day 3 of the intervention |
| Laboratory examination | Changes of cytokines (IL-1,6,10,12) from baseline to 3rd day of the intervention | baseline, Day 3 of the intervention |
| Heart rate variability | Changes from baseline to 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention | baseline, 1st day of the intervention, 2nd day of the intervention, 3rd day of the intervention |
| D004599 |
| Electric Stimulation Therapy |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
| D004561 | Transcutaneous Electric Nerve Stimulation |
| D000698 | Analgesia |
| D000760 | Anesthesia and Analgesia |
| D000758 | Anesthesia |