A randomized, controlled clinical trial of acupoint catgut embedding as an effective control of functional anorectal pain.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
03 Nov 2023
03 Nov 2023
Historique:
medline:
8
11
2023
pubmed:
7
11
2023
entrez:
7
11
2023
Statut:
ppublish
Résumé
Patients with functional anorectal pain (FAP) usually feel pain in the anal region, foreign body sensation, and defecation disorders. The pain may radiate to the perineum, thighs, and waist. Conventional biofeedback, local nerve block and surgical treatment have certain limitations. Thread-embedding acupuncture (TEA) is a complementary and alternative therapy, which is widely used in the clinical practice of traditional Chinese medicine to treat functional anorectal pain. This study evaluated the efficacy and safety of the catgut-embedding acupuncture in patients with FAP. FAP patients were enrolled and randomly divided into a thread-embedding acupuncture group (n = 35) and a sham-embedding acupuncture control group (n = 36). Patients underwent treatment twice monthly for 2 months and were assessed before and after treatments for visual analogue scales (VAS) of anorectal pain, VAS of lumbar pain or soreness, VAS of abdominal distension or pain, anal incontinence index, and SF-36 quality of life. The SF-36 quality of life score included assessment of physical functioning, role-physical, bodily-pain, general health, role-emotional, social functioning, vitality, and mental health. The total effective rate was 85.71% for the treatment group versus 8.33% of the controls after 2 months (P < .001). The patients' anal rectum VAS score was significantly higher after treatment versus pretreatment (P < .01), while the physical functioning, role-physical, bodily-pain, role-emotional, and mental health in the experimental group and the role-emotional, and mental health in the control group were all significantly improved versus pretreatment (P < .05). The anorectal VAS score, anal incontinence index, and the SF-36 scores of the physical functioning, role-physical, bodily-pain, role-emotional, and mental health were better in the treatment group compared to the control group (P < .05). Most importantly, there were no adverse reactions observed in either group during the treatment. The thread-embedding acupuncture treatment effectively and safely improved the emotional anxiety and quality of life in FAP patients.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with functional anorectal pain (FAP) usually feel pain in the anal region, foreign body sensation, and defecation disorders. The pain may radiate to the perineum, thighs, and waist. Conventional biofeedback, local nerve block and surgical treatment have certain limitations. Thread-embedding acupuncture (TEA) is a complementary and alternative therapy, which is widely used in the clinical practice of traditional Chinese medicine to treat functional anorectal pain. This study evaluated the efficacy and safety of the catgut-embedding acupuncture in patients with FAP.
METHODS
METHODS
FAP patients were enrolled and randomly divided into a thread-embedding acupuncture group (n = 35) and a sham-embedding acupuncture control group (n = 36). Patients underwent treatment twice monthly for 2 months and were assessed before and after treatments for visual analogue scales (VAS) of anorectal pain, VAS of lumbar pain or soreness, VAS of abdominal distension or pain, anal incontinence index, and SF-36 quality of life. The SF-36 quality of life score included assessment of physical functioning, role-physical, bodily-pain, general health, role-emotional, social functioning, vitality, and mental health.
RESULT
RESULTS
The total effective rate was 85.71% for the treatment group versus 8.33% of the controls after 2 months (P < .001). The patients' anal rectum VAS score was significantly higher after treatment versus pretreatment (P < .01), while the physical functioning, role-physical, bodily-pain, role-emotional, and mental health in the experimental group and the role-emotional, and mental health in the control group were all significantly improved versus pretreatment (P < .05). The anorectal VAS score, anal incontinence index, and the SF-36 scores of the physical functioning, role-physical, bodily-pain, role-emotional, and mental health were better in the treatment group compared to the control group (P < .05). Most importantly, there were no adverse reactions observed in either group during the treatment.
CONCLUSION
CONCLUSIONS
The thread-embedding acupuncture treatment effectively and safely improved the emotional anxiety and quality of life in FAP patients.
Identifiants
pubmed: 37933076
doi: 10.1097/MD.0000000000035462
pii: 00005792-202311030-00108
pmc: PMC10627639
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e35462Informations de copyright
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Wald A. Functional anorectal and pelvic pain. Gastroenterol Clin North Am. 2001;30:243–52.
Grimaud J-C, Bouvier M, Naudy B, et al. Manometric and radiologic investigations and biofeedback treatment of chronic idiopathic anal pain. Dis Colon Rectum. 1991;34:690–5.
Rao SSC, Bharucha AE, Chiarioni G, et al. Anorectal disorders. Gastroenterology. 2016;150:1430–1442.e1434.
Chiarioni G, Nardo A, Vantini I, et al. Biofeedback is superior to electrogalvanic stimulation and massage for treatment of levator ani syndrome. Gastroenterology. 2010;138:1321–9.
de Parades V, Etienney I, Bauer P, et al. Proctalgia fugax: demographic and clinical characteristics. what every doctor should know from a prospective study of 54 patients. Dis Colon Rectum. 2007;50:893–8.
Aziz I, Palsson OS, Törnblom H, et al. Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study. Lancet Gastroenterol Hepatol. 2018;3:252–62.
Hui XS, Xu Y, Li HS, et al. Efficacy evaluation of electroacupuncture at Dong’s points combined with biofeedback in the treatment of functional anorectal pain. World J Acupunct Moxibustion. 2020;30:256–61.
Xie CY, Xiao HR, Wu CC, et al. Thirty-six cases of functional anorectal pain treated with heat-sensitization moxibustion. World J Acupunct Moxibustion. 2016;26:49–51.
Atkin GK, Suliman A, Vaizey CJ. Patient characteristics and treatment outcome in functional anorectal pain. Dis Colon Rectum. 2011;54:870–5.
Shi P, Chai XQ, Lei B, et al. Research progress of acupuncture in the treatment of functional anorectal pain. Mod Tradit Chin Med. 2019;39:134–6.
Zhang JJ. Study on the characteristics of pelvic floor dysfunction and TCM syndrome types of female functional anorectal pain [Master], Nanjing University of traditional Chinese Medicine. 2018.
Li J, Zhang F, Wang W, et al. Acupoint catgut embedding for patients with migraine. Medicine (Baltimore). 2020;99:e21268.
Zhang C, Liao XZ, Hong DM, et al. Application of acupoint catgut embedding in anorectal department. Chin Med Mod Distance Educ China. 2015;13:70–2.
Sun YQ, Zheng XP, Zhang CR. Clinical observation of thread-embedding acupuncture on the treatment of functional anorectal pain. Chin J Tradit Chin Med Pharm. 2020;35:2137–9.
Drossman DA, Hasler WL. Rome IV—functional GI disorders: disorders of gut-brain interaction. Gastroenterology. 2016;150:1257–61.
Simren M, Palsson OS, Whitehead WE. Update on Rome IV criteria for colorectal disorders: implications for clinical practice. Curr Gastroenterol Rep. 2017;19:15.
Rao SSC, Benninga MA, Bharucha AE, et al. ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders. Neurogastroenterol Motil. 2015;27:594–609.
Medical Administration Department of National Administration of Traditional Chinese Medicine. The Diagnostic and treatment Plan of traditional Chinese Medicine for 105 Diseases in 24 Professionals(bound version). Beijing: China Traditional Chinese Medicine Society. 2011.
Li J, Liu C, Li N, et al. Scaling the SF-36 in a Chinese population. J West China Univ Med Sci. 2001;32:36–38 + 47.
Xue YH. The literature evaluation and clinical study of randomized controlled trials of treating functional anorectal pain with acupuncture [Doctor], Nanjing University of Traditional Chinese Medicine; 2017.
Zhang JJ, Ding YJ, Ding SQ, et al. Study on TCM syndrome type of functional anorectal pain. J Liaoning Univ Tradit Chin Med. 2018;20:107–9.
Xu BB, Yu Z, Xu B. Overview of the two-way regulatory effect of acupuncture on gastrointestinal motility. Zhongguo Zhen Jiu. 2012;32:765–8.
Angell M, Kassirer JP. Alternative medicine—the risks of untested and unregulated remedies. N Engl J Med. 1998;339:839–41.
Goldrosen MH, Straus SE. Complementary and alternative medicine: assessing the evidence for immunological benefits. Nat Rev Immunol. 2004;4:912–21.
Cheung F. TCM: made in China. Nature. 2011;480:S82–3.
Eigenschink M, Dearing L, Dablander TE, et al. A critical examination of the main premises of Traditional Chinese Medicine. Wien Klin Wochenschr. 2020;132:260–73.
Yang LX, Li J, Liu Y, et al. Clinical observation of acupoint catgut embedding to regulate gastrointestinal hormones and intervene in prediabetes. Clin J Tradit Chin Med. 2022;34:1137–41.
Zhang WJ, Liang YZ, Zhang WQ, et al. The research progress on mechanism and clinical value of acupoint catgut implanting in the prevention and treatment of gastrointestinal dysfunction. World Chin Med. 2021;16:844–8.
Leem J, Kim H, Jo H-G, et al. Efficacy and safety of thread embedding acupuncture combined with conventional acupuncture for chronic low back pain. Medicine (Baltimore). 2018;97:e10790.
Zhang R, Lao L, Ren K, et al. Mechanisms of acupuncture–electroacupuncture on persistent pain. Anesthesiology. 2014;120:482–503.
Ulloa L. Electroacupuncture activates neurons to switch off inflammation. Nature. 2021;598:573–4.
Jiang QW. Clinical study on the treatment of lumbar disc herniation by acupoint catgut embedding based on meridian theory [Master], Nanjing University of Traditional Chinese Medicine; 2021.
Govaert B, Melenhorst J, van Kleef M, et al. Sacral neuromodulation for the treatment of chronic functional anorectal pain: a single center experience. Pain Pract. 2010;10:49–53.