World journal of gastrointestinal surgery · 2025
Effects of Chinese acupuncture on nausea and vomiting after cholecystectomy: A retrospective study.
СтатьяНазвание и аннотация: Перевод в очереди
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Miao Yue, Zhang Ren
Аннотация
BACKGROUND: Post-operative nausea and vomiting (PONV) after cholecystectomy occurs in 40%-75% of patients, significantly affecting recovery and satisfaction.
AIM: To evaluate the effectiveness and safety of acupuncture at Hegu (LI4) and Zusanli (ST36) acupoints in preventing PONV in patients undergoing cholecystectomy.
METHODS: This retrospective study included 240 patients undergoing cholecystectomy (January 2022 to December 2023), randomized to acupuncture (n = 120) or control groups (n = 120). The acupuncture group received bilateral LI4 and ST36 acupuncture immediately post-surgery and 6 hours later; controls received routine care. Primary outcomes included PONV incidence, severity (visual analogue scale score), and time to first occurrence.
RESULTS: The total PONV incidence in the acupuncture group was significantly lower than in the control group (28.3% vs 47.5%, P < 0.01). Stratified analysis showed that in the laparoscopic group, the acupuncture group's PONV incidence was 26.7%, significantly lower than the control group's 45.6% (P < 0.01); in the open surgery group, the acupuncture group was 33.3%, lower than the control group's 53.3% (P < 0.05). The acupuncture group showed significantly reduced symptom severity (visual analogue scale score 2.7 ± 1.4 vs 4.5 ± 1.8, P < 0.01), delayed time to first occurrence (8.4 ± 2.1 hours vs 4.2 ± 1.5 hours, P < 0.01), with the symptom-free period extended by 4.2 hours. The acupuncture group had a higher proportion of mild symptoms (76.5% vs 35.1%) and a significantly increased proportion of symptom-free patients within 6 hours post-surgery (67.6% vs 28.1%, P < 0.01). Rescue antiemetic medication usage was significantly reduced in the acupuncture group (18.3% vs 35.8%, P < 0.01). Patient satisfaction scores in the acupuncture group were significantly better than the control group (4.6 ± 0.7 vs 3.8 ± 0.9, P < 0.01), with hospital stay shortened by 0.5 days (2.1 ± 0.8 days vs 2.6 ± 1.1 days, P < 0.05). Subgroup analysis showed that acupuncture was more effective in patients ≤ 45 years (incidence reduction 23.5% vs > 45 years group 16.8%), with significant efficacy in high-risk patients (Apfel score ≥ 3) (36.2% vs 62.2%, P < 0.01). Safety analysis showed only 7 cases (5.8%) of mild adverse reactions in the acupuncture group, all self-resolved with no serious adverse events.
CONCLUSION: Acupuncture at LI4 and ST36 acupoints significantly reduces PONV incidence and severity after cholecystectomy, with an excellent safety profile. This non-pharmacological intervention offers particular value for high-risk patients and those with medication contraindications.
AIM: To evaluate the effectiveness and safety of acupuncture at Hegu (LI4) and Zusanli (ST36) acupoints in preventing PONV in patients undergoing cholecystectomy.
METHODS: This retrospective study included 240 patients undergoing cholecystectomy (January 2022 to December 2023), randomized to acupuncture (n = 120) or control groups (n = 120). The acupuncture group received bilateral LI4 and ST36 acupuncture immediately post-surgery and 6 hours later; controls received routine care. Primary outcomes included PONV incidence, severity (visual analogue scale score), and time to first occurrence.
RESULTS: The total PONV incidence in the acupuncture group was significantly lower than in the control group (28.3% vs 47.5%, P < 0.01). Stratified analysis showed that in the laparoscopic group, the acupuncture group's PONV incidence was 26.7%, significantly lower than the control group's 45.6% (P < 0.01); in the open surgery group, the acupuncture group was 33.3%, lower than the control group's 53.3% (P < 0.05). The acupuncture group showed significantly reduced symptom severity (visual analogue scale score 2.7 ± 1.4 vs 4.5 ± 1.8, P < 0.01), delayed time to first occurrence (8.4 ± 2.1 hours vs 4.2 ± 1.5 hours, P < 0.01), with the symptom-free period extended by 4.2 hours. The acupuncture group had a higher proportion of mild symptoms (76.5% vs 35.1%) and a significantly increased proportion of symptom-free patients within 6 hours post-surgery (67.6% vs 28.1%, P < 0.01). Rescue antiemetic medication usage was significantly reduced in the acupuncture group (18.3% vs 35.8%, P < 0.01). Patient satisfaction scores in the acupuncture group were significantly better than the control group (4.6 ± 0.7 vs 3.8 ± 0.9, P < 0.01), with hospital stay shortened by 0.5 days (2.1 ± 0.8 days vs 2.6 ± 1.1 days, P < 0.05). Subgroup analysis showed that acupuncture was more effective in patients ≤ 45 years (incidence reduction 23.5% vs > 45 years group 16.8%), with significant efficacy in high-risk patients (Apfel score ≥ 3) (36.2% vs 62.2%, P < 0.01). Safety analysis showed only 7 cases (5.8%) of mild adverse reactions in the acupuncture group, all self-resolved with no serious adverse events.
CONCLUSION: Acupuncture at LI4 and ST36 acupoints significantly reduces PONV incidence and severity after cholecystectomy, with an excellent safety profile. This non-pharmacological intervention offers particular value for high-risk patients and those with medication contraindications.