Self-administered acupressure for chronic severe functional constipation: A study protocol for a randomized controlled trial

Background:Functional constipation is a disease with a high incidence, which has a bad effect on general health, mental health, and social functioning. However, current treatment is sometimes unsatisfactory. Acupuncture has been proven effective in some randomized controlled trials. Acupressure is a subtype of acupuncture and can be manipulated by the patients at home. But the evidence is limited now. This study aims to provide some strict evidence for the use of self-administered acupressure in the treatment of functional constipation.Methods:This 2-armed, parallel, nonspecific controlled, randomized trial will be conducted at The Third Affiliated Hospital of Zhejiang Chinese Medical University in Hangzhou. A total of 154 FC patients will be enrolled into the acupoint group and the sham acupoint group with a ratio of 1:1 into this trial and it will consist of a 2-week run-in period, an 8-week intervention period, and an 8-week follow-up period. The treatment will be done by the patients themselves at home twice a day and they should sign in on the WeChat APP every day to make sure they have done the acupressure. The outcome will also be collected in WeChat APP through the diary and questionnaires. For the one who is unable to use the WeChat, the print edition of the diary and questionnaires are provided and the supervision will be done by the short message. The primary outcome will be the proportion of participants whose CSBM≥3 during week 3 to 10. The secondary outcome will be the proportion of participants whose CSBM ≥3 between 2 groups in week 11 to 18, Spontaneous bowel movements, Bristol Stool Form Scale, Straining severity scores, Patient assessment of constipation quality of life, and Medicine use.Discussion:Acupressure is not an invasive method and can be done by the patient itself at home. We hope this trial will provide credible evidence to the application of self-acupressure for the management of severe chronic functional constipation.Trial registration:This trial has been registered at the Chinese Clinical Trial Registry (ChiCTR2000038594).     

Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study

Background:Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-aP.Method:A multicenter, prospective, randomized, parallel-design, open label interventional study to estimate the effectiveness of zolpidem (10 mg) oral tablets versus acupressure on sleep quality and quality of life in patients with CKD-aP on hemodialysis. A total of 58 hemodialysis patients having sleep disturbance due to CKD-aP completed the entire 8-week follow-up. The patients were divided into a control (acupressure) group of 28 patients and an intervention (zolpidem) group of 30 patients.Results:A total of 58 patients having CKD-aP and sleep disturbance were recruited. In the control group there was a reduction in the PSQI score with a mean ± SD from 12.28 ± 3.59 to 9.25 ± 3.99, while in the intervention group the reduction in PSQI score with a mean ± SD was from 14.73 ± 4.14 to 10.03 ± 4.04 from baseline to endpoint. However, the EQ5D index score and EQ-visual analogue scale (VAS) at baseline for the control group with a mean ± SD was 0.49 ± 0.30 and 50.17 ± 8.65, respectively, while for the intervention group the values were 0.62 ± 0.26 and 47.17 ± 5.82, respectively. The mean EQ5D index score in the control group improved from 0.49 ± 0.30 to 0.53 ± 0.30, but in the intervention group there was no statistical improvement in mean EQ5D index score from 0.62 ± 0.26 to 0.62 ± 0.27 from baseline to week 8. The EQ 5D improved in both groups and the EQ-VAS score was 2.67 points higher at week 8 as compared to baseline in the control group, while in the intervention group the score was 3.33 points higher at week 8 as compared to baseline. Comparing with baseline, the PSQI scores were significantly reduced after week 4 and week 8 (P =  < .001). Furthermore, at the end of the study, the PSQI scores were significantly higher in the control as compared to the intervention group (P = .012).Conclusion:An improvement in sleep quality and quality of life among CKD-aP patients on hemodialysis has been observed in both the control and intervention groups. Zolpidem and acupressure safety profiling showed no severe adverse effect other that drowsiness, nausea and daytime sleeping already reported in literature of zolpidem.     

不同体位下指压不同穴位对脑卒中患者胫前肌和腓骨长、短肌的表面肌电影响

摘要 目的：优化指压穴位刺激法在脑卒中偏瘫治疗中的应用。 方法：30例偏瘫患者,分别在仰卧伸膝0°位和屈膝90°位下指压偏瘫侧足三里、足临泣穴,对比刺激即刻3s、停止刺激后第一个3s、第二个3s、第三个3s的胫前肌和腓骨长、短肌最大等长收缩的积分肌电值（iEMG）。 结果：①刺激前后比较：两种体位下,指压两个穴位,刺激即刻的iEMG明显高于刺激前（P<0.05）,停止刺激后的三个3s的iEMG呈逐渐下降趋势。②穴位间比较：两种体位下,均表现为指压足三里穴,胫前肌刺激即刻的iEMG、停止刺激后的三个3s的iEMG均明显高于足临泣穴（P<0.05）;指压足临泣穴,腓骨长、短肌刺激即刻的iEMG、停止刺激后的三个3s的iEMG均明显高于足三里穴（P<0.05）。③体位间比较：仰卧屈膝90°位指压两个穴位,胫前肌刺激即刻、停止刺激后第一个3s的iEMG明显高于伸膝0°位（P<0.05）;腓骨长、短肌刺激即刻的iEMG明显高于伸膝0°位（P<0.05）。 结论：①指压刺激偏瘫侧足三里、足临泣穴均可诱发偏瘫侧胫前肌和腓骨长、短肌收缩,且即刻效应和延续效应良好。②指压足三里穴对诱发胫前肌收缩的即刻效应和延续效应优于足临泣穴;指压足临泣穴对诱发腓骨长、短肌收缩的即刻效应和延续效应优于足三里穴。③仰卧屈膝90°位,指压刺激足三里、足临泣穴对诱发胫前肌和腓骨长、短肌收缩的即刻效应明显优于伸膝0°位,延续效应无明显差异。     

"因特网辅助耳穴戒烟"对青少年戒烟的成效

目的探讨一套以计算机因特网辅助耳穴戒烟方案对青少年戒烟之成效.方法以实验研究设计收案77位高中职学生,以非随机分配至因特网辅助耳穴戒烟组及耳穴戒烟组.分别提供不同介入措施,但皆以血清尼古丁浓度、自我效能作为戒烟成效之指标.研究数据以SPSS 10.0版软件包进行数据分析.结果以血清尼古丁检定戒烟率,因特网辅助耳穴组(15.78%)明显高于耳穴组(2.5%).两组均能有效增进自我效能.普遍而言,研究对象认为因特网辅助耳穴戒烟对戒烟有具体的帮助.结论可提供相关单位做为青少年戒烟方式之参考,建议未来研究者在本研究的基础下,进一步以更严谨的研究设计探讨耳穴的适用范围及成效.     

针刺配合指压法对妇科腹腔镜手术后恶心呕吐症的干预研究

目的：观察比较针刺内关配合腧穴、指揉按压法在妇科腹腔镜手术后恶心呕吐症中的干预研究。方法：选择ASAⅠ-Ⅱ116例妇科腹腔镜手术患者,随机分为五组：针刺指揉组（AF,n=23）、恩丹西酮组（OH,n=23）、甲氧氯普胺组（MP,n=23）、氟哌利多组（DR,n=23）和生理盐水组（NS,n=24）。实施全凭静脉麻醉及术后镇痛（patient controlled intravenous analgesia,PCIA）。常规连续监测收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）外,采用A-Line麻醉-镇静深度监测仪监测听觉诱发电位指数（AAI）值,指导麻醉药物的使用。结果：针刺指揉组、恩丹西酮组、甲氧氯普胺组与氟哌利多组VAS评分相当,与生理盐水组比较P〈0.01,各试验组之间比较P〉0.05,表明针刺指揉组、恩丹西酮组、甲氧氯普胺组和氟哌利多组疗效相同。结论：针刺配合指揉按压法在防治妇科腹腔镜恶心呕吐中适用于轻、中度恶心呕吐。     

中药敷贴联合按摩点穴治疗老年功能性便秘的随机对照临床研究

目的观察中药敷贴联合按摩点穴治疗老年功能性便秘的临床疗效。方法将68例符合罗马Ⅲ诊断标准的老年功能性便秘患者随机分为治疗组（35例）和对照组（33例）,分别采用中药敷贴联合按摩点穴、麻仁软胶囊治疗。两组疗程均为20天。随访3个月,通过便秘症状评估量表积分变化情况评价临床疗效。结果治疗组总有效率为94.29%,对照组为84.85%;组间临床疗效比较,差异无统计学意义（P〉0.05）。两组治疗后各项症状积分及总积分均明显降低（P〈0.05）;组间治疗后比较,排便时间和腹胀积分差异有统计学意义（P〈0.05）。治疗组随访时排便间症状积分增加（P〈0.05）,其余症状积分及总积分与治疗后差异无统计学意义（P〉0.05）;对照组随访时各项症状积分及总积分与治疗后比较,差异均有统计学意义（P〈0.05）。组间随访时比较,各项症状积分及总积分差异均有统计学意义（P〈0.05）。结论中药敷贴联合按摩点穴疗法对老年人功能性便秘具有较好的临床疗效。     

中医穴位按摩在母婴分离产妇乳房护理中的作用

目的探讨中医穴位按摩在母婴分离产妇乳房护理中的作用。方法选择母婴分离产妇120例,随机分成研究组及对照组各60例,研究组在产后开始连续5d进行中医穴位按摩,对照组则进行常规乳房护理。比较两组产后开始泌乳时间、泌乳量充足时间、5d产妇乳房胀痛程度的主观评分、乳房硬度、母乳喂养率及乳腺炎的发生率。结果通过中医穴位按摩两组泌乳时间、泌乳量充足时间、5d产妇乳房胀痛程度的主观评分、乳房硬度、母乳喂养率差异有统计学意义,乳腺炎的发生率差异无统计学意义。结论中医穴位按摩可明显减轻母婴分离产妇乳房胀痛程度及硬度,使泌乳时间提前,母乳喂养率提高。     

Effects of a nurse‐led acupressure programme for stroke patients in China

Aim and objective. To examine the effects of a nurse‐led acupressure programme on the recovery of motor function and daily activities of stroke patients. Background. Stroke is one of the main causes of death and permanent physical disability in the world. The traditional Chinese medicine (TCM) is widely used for the treatment and rehabilitation of people with stroke in China. Physiotherapy or occupational therapy cannot be performed several times a day. Therefore, researchers and healthcare providers have been seeking effective and efficient alternative strategies for the rehabilitation of stroke patients. Acupressure, non‐invasive and widely accessible to any healthcare professionals, is one of the promising alternatives. Methods. Seventy‐eight stroke patients were recruited and randomly assigned into an intervention or control group, with 39 patients in each. The intervention group received acupressure plus routine care, while the control group received only routine care only. The acupressure treatment was carried out by nurses. Patient’s activities of daily living (ADL) and motor function from both groups were evaluated at the point of recruitment, and at the end of the first and third month after stroke. Results. The ADL and the Fugl‐Meyer motor scores in the intervention group were significantly higher than those in the control group at the end of the third month (p < 0·05). Conclusion. Nurse‐led acupressure programme had positive effects on the recovery of motor function and daily activities of stroke patients. Our study suggests that nurse‐led acupressure programmes play an important role in the recovery of stroke patients. Relevance to clinical practice. Healthcare providers need to think about alternative care methods including acupressure for the rehabilitation of stroke patients. Acupressure is one of the promising alternatives nursing intervention for stroke patients in practice.     

穴位按摩对肺癌患者阿片类药物引发便秘的防治效果

目的：探讨穴位按摩对肺癌患者口服阿片类止痛药引发便秘的防治效果。方法便利选取2010年6月至2012年2月东阳市人民医院收治的肺癌疼痛并口服吗啡缓释片控制疼痛的患者88例,采用随机数字表法分为治疗组和对照组各44例。对照组进行常规护理及便秘知识健康教育,治疗组在对照组的基础上实施穴位按摩,比较两组患者的便秘发生率及便秘严重程度。结果治疗组的便秘发生率（63．64％）低于对照组（88．64％）,在粪便性状、排便频度、排便困难程度、下坠感、腹胀感等方面的得分均低于对照组,差异均有统计学意义（P ＜0．01）。结论对口服阿片类止痛药的肺癌患者进行预防性的穴位按摩,可有效降低患者的便秘发生率,缓解便秘症状,提高患者的舒适度。     

芒硝敷脐联合穴位按摩对重症急性胰腺炎胃肠功能的影响

重症急性胰腺炎（severe acute pancreatitis,SAP）常并发急性胃肠损伤（acute gastrointestinal injury,AGI）,早期积极有效治疗可以恢复患者的胃肠功能,明显改善SAP的预后[1-2]。近几年,中西医结合治疗SAP已逐渐成为一个新的方向[3]。