Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension:A randomized-controlled study

作     者：Wing-Wa Leung Alice YM Jones Simon SM Ng Cherry YN Wong Janet FY Lee 

作者机构：Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHung HomHong Kong 999077China Faculty of Health SciencesThe University of SydneySydneyNSW 2006Australia Division of Colorectal SurgeryDepartment of SurgeryThe Chinese University of Hong KongPrince of Wales HospitalShatinHong Kong 999077China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第3期

页      面：381-388页

核心收录：

学科分类：1005[医学-中医学] 1002[医学-临床医学] 100512[医学-针灸推拿学] 10[医学] 

主　　题：Colonoscopy Rectal discomfort Transcu-taneous electrical nerve stimulation Acupuncture Visceral pain 

摘      要：AIM:To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation(Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension. METHODS:Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS(no electrical output)over acupuncture points Hegu(largeintestine 4),Neiguan(pericardium 6)and Zusanli(stomach 36).A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects rectum.A step-wise(4 mmHg)increase in balloon pressure was induced until maximal tolerable or 48 *** analogue scale and a 5-point subjective discomfort scale(no perception,first per-ception of distension,urge to defecate,discomfort/ pain and extreme pain)were used to assess rectal discomfort at each distension *** beta-endorphin levels were measured before,immediately after intervention,at 24 mmHg and at maximal toler- able distension pressure. RESULTS:There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two *** threshold levels were higher in the Acu-TENS group when compared to the placebo group,but the difference reached statistical significance only at the sensationsurge to defecateandpain.The distension pressures recorded at theurge to defecatesensation for the Acu-TENS and placebo-TENS groups were 28.0±4.5 mmHg and 24.6±5.7 mmHg,respectively(P=0.043);and the pressures recorded for thepainsensation for these two groups were 36.0±4.2 mmHg and 30.5± 4.3 mmHg respectively(P=0.002).Compared to the placebo group,a higher number of participants in the Acu-TENS group tolerated higher distension pressures (40 mmHg)(65%in Acu-TENS vs 25%in placebo, P=0.02).The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg(1.31±0.40 ng/mL vs 1.04±0.43 ng/mL,P= 0.044)and at maximal inflation p