ChiCTR2500113425 版本V1.0 版本创建时间2025/11/28 08:49:00 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2500113425 

最近更新日期:

Date of Last Refreshed on:

2025-11-28 08:48:40 

注册时间:

Date of Registration:

2025-11-28 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

经皮耳迷走神经刺激对慢性鼻窦炎患者功能性鼻内镜术后疼痛的影响:一项随机对照试验

Public title:

The Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Pain in Patients with Chronic Sinusitis Undergoing Functional Endoscopic Sinus Surgery: A Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

经皮耳迷走神经刺激对慢性鼻窦炎患者功能性鼻内镜术后疼痛的影响:一项随机对照试验

Scientific title:

The Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Pain in Patients with Chronic Sinusitis Undergoing Functional Endoscopic Sinus Surgery: A Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

况蕊幸 

研究负责人:

彭丽桦 

Applicant:

Ruixing Kuang 

Study leader:

Lihua Peng  

申请注册联系人电话:

Applicant telephone:

+86 177 2352 7176

研究负责人电话:

Study leader's telephone:

+86 158 2344 3968

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

1439611330@qq.com

研究负责人电子邮件:

Study leader's E-mail:

plhcqmu@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

重庆市渝中区友谊路1号

研究负责人通讯地址:

重庆市渝中区友谊路1号

Applicant address:

1 Youyi Road, Yuzhong District, Chongqing

Study leader's address:

1 Youyi Road, Yuzhong District, Chongqing

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

重庆医科大学附属第一医院

Applicant's institution:

The First Affiliated Hospital of Chongqing Medical University

研究负责人所在单位:

重庆医科大学附属第一医院

Affiliation of the Leader:

The First Affiliated Hospital of Chongqing Medical University

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025年科研伦审(2025-924-01)

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

重庆医科大学附属第一医院伦理委员会

Name of the ethic committee:

Ethics Committee of the First Affiliated Hospital of Chongqing Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-11-21 00:00:00

伦理委员会联系人:

严青

Contact Name of the ethic committee:

Qing Yan

伦理委员会联系地址:

重庆市渝中区友谊路1号

Contact Address of the ethic committee:

1 Youyi Road, Yuzhong District, Chongqing

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 23 8901 1876

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

重庆医科大学附属第一医院

Primary sponsor:

The First Affiliated Hospital of Chongqing Medical University

研究实施负责(组长)单位地址:

重庆市渝中区友谊路1号

Primary sponsor's address:

1 Youyi Road, Yuzhong District, Chongqing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆

市(区县):

重庆

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属第一医院

具体地址:

重庆市渝中区友谊路1号

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Address:

1 Youyi Road, Yuzhong District, Chongqing

经费或物资来源:

重庆医科大学附属第一医院研究生基金

Source(s) of funding:

Postgraduate fund of the First Affiliated Hospital of Chongqing Medical University

Target disease:

Postoperative Pain

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究拟选择行插管全麻下择期鼻内镜手术治疗慢性鼻窦炎的患者,以期探索经皮耳迷走神经刺激这一非药物干预对其术后疼痛的影响。  

Objectives of Study:

This study aims to select patients undergoing elective endoscopic sinus surgery for chronic sinusitis under general anesthesia with endotracheal intubation, in order to explore the effects of transcutaneous auricular vagus nerve stimulation—a non-pharmacological intervention—on postoperative pain.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1: 18岁 ≤年龄 ≤65岁 2: ASA分级Ⅰ-Ⅲ级 3: 18kg/m^2<BMI≤30 kg/m^2 4: 经鼻内镜和/或鼻窦CT证实,且症状持续>12周(符合《中国慢性鼻窦炎诊断和治疗指南》),排除继发于其他疾病的CRS(如:继发于牙源性疾病、真菌感染、囊性纤维化、原发性纤毛不动综合征、血管炎、免疫球蛋白相关疾病和免疫缺陷等的CRS); 5: 术前影像及内镜仅提示慢性鼻窦炎/鼻息肉,无其他占位、骨质破坏、软组织浸润、真菌倾向等; 6: 首次FESS,或既往仅行部分鼻窦开放且无广泛瘢痕化; 7: 合并心、肺、肝、肾、甲状腺功能异常及凝血功能障碍者,控制水平优于排除标准所列相应值; 8: 能够理解、阅读并签署知情同意书,教育年限 ≥ 9 年,语言及认知功能正常,可配合研究流程。

Inclusion criteria

1. Age between 18 and 65 years old 2. ASA Classification I-III 3. 18kg/m^2

排除标准:

1.拒绝签署知情同意者; 2.语言或认知障碍:构音障碍、失语症、痴呆、既往脑部手术或任何脑退行性疾病导致无法完整表达或理解指令者; 3.严重精神疾病:精神分裂症(含自杀/自残倾向)、双相情感障碍、自闭症谱系障碍、注意缺陷多动障碍等确诊且影响合作的情况;神经系统疾病(如癫痫、帕金森、多发性硬化、重症肌无力、肌营养不良等) 4.合并其他慢性疼痛或神经病变:腰背痛、颈肩痛、偏头痛、三叉神经痛、纤维肌痛综合征、截肢后幻肢痛等; 糖尿病周围神经病变、任何原因导致的周围神经损伤,或既往确诊迷走神经功能异常/反射过度敏感者; 5.近期干预或用药:既往4周内曾接受或目前正在接受任何形式的外周神经调控干预者(包括但不限于针灸/电针、耳穴压豆、经颅磁刺激、经皮耳迷走神经刺激、经皮电神经刺激、外周神经阻滞、神经射频消融、脊髓或外周神经电刺激);近4周内阿片类镇痛药物使用史; 6.耳部禁忌:金属过敏者、先天(耳部畸形)或后天(耳部创伤、感染、手术、耳部皮肤知觉障碍等)造成耳部结构或功能异常无法配合者、严重皮肤疾病(如严重湿疹或皮炎); 7.具有植入式设备(如心脏起搏器、植入式除颤仪、耳蜗植入物、深部脑刺激器、骨科金属植入影响耳周电磁场者); 8.伴有严重心、肺、肝、肾、甲状腺功能异常及凝血功能障碍 a. 高血压:收缩压≥180 mmHg 或舒张压≥110 mmHg,或需静脉降压药维持; b. 心衰:NYHA Ⅲ级或Ⅳ级,或左室射血分数<40%; c. 心律失常:持续性窦性心动过缓(静息心率<50 次/分)、二度Ⅱ型及以上房室传导阻滞、RR 长间歇≥2.5 s,或任何需药物/器械治疗的心律失常; d. 近3个月内有静息或低活动即诱发的心绞痛、或已诊断为不稳定型心绞痛;近6个月内发生急性心肌梗死(STEMI/NSTEMI); e. 肝功能:Child-Pugh 分级 ≥B 或 ALT/AST>3×ULN; f. 肺功能:FEV1/FVC<50% 或 FEV1%预计值<50%; 需长期家庭氧疗(≥15 h/日)或长期无创通气;动脉血气(未吸氧):PaO2<60 mmHg 或 PaCO2>50 mmHg; g. 肾功能:eGFR<30 mL·min?1·1.73 m?2或需行透析者; h. 甲状腺功能:TSH<0.1 mIU/L 或>10 mIU/L,或TSH 4.5–10 mIU/L 伴 FT4 正常但近3个月需调整用药; i. 凝血功能障碍:近7天内出现需医疗干预的任何部位活动性出血(包括但不限于如鼻腔持续渗血、呕血、黑便、肉眼血尿或异常子宫出血等);或实验室检查示血小板<50×10?/L、INR>1.5(未抗凝)、APTT>1.5×ULN、纤维蛋白原<1.0 g/L、D-二聚体>2×ULN且PT延长>5 s;或既往确诊血友病A/B、血管性血友病及其他遗传性/获得性凝血因子缺乏; 9.存在酒精使用障碍(Alcohol Use Disorder,AUD)或高风险饮酒者:(酒精使用障碍筛查量表,Alcohol Use Disorders Identification Test,AUDIT≥8分)。

Exclusion criteria:

1. Refusing to sign informed consent; 2. Language or cognitive impairment: individuals with articulation disorders, aphasia, dementia, previous brain surgery, or any neurodegenerative disease who are unable to fully express or understand instructions; 3. Serious mental illnesses: schizophrenia (including suicidal/self injurious tendencies), bipolar disorder, autism spectrum disorder, attention deficit hyperactivity disorder, and other diagnosed conditions that affect cooperation; Neurological disorders (such as epilepsy, Parkinson's disease, multiple sclerosis, myasthenia gravis, muscular dystrophy, etc.) 4. Combined with other chronic pain or neuropathy: lower back pain, neck and shoulder pain, migraine, trigeminal neuralgia, fibromyalgia syndrome, phantom limb pain after amputation, etc; Diabetes peripheral neuropathy, peripheral nerve injury caused by any reason, or vagus nerve dysfunction/hyperreflexia diagnosed in the past; 5. Recent intervention or medication: those who have received or are currently receiving any form of peripheral nerve regulation intervention in the past 4 weeks (including but not limited to acupuncture and moxibustion/electroacupuncture, ear point pressing, transcranial magnetic stimulation, transcutaneous auricular vagus nerve stimulation, transcutaneous electric nerve stimulation, peripheral nerve block, nerve radiofrequency ablation, spinal cord or peripheral nerve electrical stimulation); History of using opioid analgesics in the past 4 weeks; 6. Ear taboos: individuals with metal allergies, congenital (ear deformities) or acquired (ear trauma, infection, surgery, ear skin perception disorders, etc.) causing structural or functional abnormalities in the ear that cannot be coordinated, severe skin diseases (such as severe eczema or dermatitis); 7. Having implantable devices (such as pacemakers, defibrillators, cochlear implants, deep brain stimulators, orthopedic metal implants that affect the electromagnetic field around the ear); 8. Accompanied by severe heart, lung, liver, kidney, thyroid dysfunction and coagulation dysfunction [ a. Hypertension: systolic blood pressure >= 180 mmHg or diastolic blood pressure >= 110 mmHg, or requiring maintenance with intravenous antihypertensive drugs; b. Heart failure: NYHA grade III or IV, or left ventricular ejection fraction<40%; c. Arrhythmia: persistent sinus bradycardia (resting heart rate<50 beats/minute), second degree type II or above atrioventricular block, RR interval >= 2.5 s, or any arrhythmia requiring medication/device treatment; d. Within the past 3 months, there has been angina pectoris induced by resting or low activity, or it has been diagnosed as unstable angina pectoris; Acute myocardial infarction (STEMI/NSTEMI) occurred within the past 6 months; e. Liver function: Child Pugh classification >= B or ALT/AST>3 × ULN; f. Pulmonary function: FEV1/FVC<50% or FEV1% expected value<50%; Long term home oxygen therapy (>= 15 hours/day) or long-term non-invasive ventilation is required; Arterial blood gas (without oxygen inhalation): PaO2<60 mmHg or PaCO2>50 mmHg; g. Renal function: eGFR<30 mL · min ?1· 1.73 m ? 2 or requiring dialysis; h. Thyroid function: TSH<0.1 mIU/L or>10 mIU/L, or TSH 4.5-10 mIU/L with normal FT4 but medication needs to be adjusted in the past 3 months; i. Coagulation dysfunction: Any active bleeding in any part of the body that requires medical intervention within the past 7 days (including but not limited to persistent nasal bleeding, vomiting, black stool, gross hematuria, or abnormal uterine bleeding); Or laboratory tests show platelet count<50 × 10 ?/L, INR>1.5 (non anticoagulated), APTT>1.5 × ULN, fibrinogen<1.0 g/L, D-dimer>2 × ULN, and PT prolongation>5 s; or previous diagnosis of hemophilia A/B, vascular hemophilia, and other genetic/acquired coagulation factor deficiencies 9. Individuals with Alcohol Use Disorder (AUD) or high-risk drinkers: (Alcohol Use Disorder Identification Test, AUDIT >= 8 points).

研究实施时间:

Study execute time:

From 2025-11-21 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-11-28 00:00:00 To 2026-12-31 00:00:00  

干预措施:

Interventions:

组别:

taVNS组

样本量:

64

Group:

taVNS Group

Sample size:

干预措施:

使用前使用 75%酒精棉片对设备及耳部刺激部位消毒、脱脂,以保证刺激部位有效接触, 再于左耳放置刺激仪,使得金属触点与耳甲腔贴合。于术前24小时内(脉宽:200us;能察觉刺激但无痛感的最大耐受强度;刺激 30 秒/停止 10秒,设定总时长为 40 分钟,使得有效刺激时长为30分钟 )及术中(脉宽:200us;入室后麻醉诱导前能察觉但无痛感的最大耐受强度;刺激 60 秒/停止 10 秒;刺激时长与手术时长相关联 )行taVNS刺激。

干预措施代码:

Intervention:

Before use, disinfect and degrease the device and the stimulating area of the ear with a 75% alcohol swab to ensure effective contact. Then place the stimulator on the left ear to ensure that the metal contact point is in contact with the ear nail cavity. Within 24 hours prior to surgery (pulse width: 200us; maximum tolerable intensity that can detect stimulation but is painless; Stimulus for 30 seconds/stop for 10 seconds, set the total duration to 40 minutes, so that the effective stimulation duration is 30 minutes) and intraoperative (pulse width: 200us; maximum tolerance intensity that can be perceived but painless before anesthesia induction after entering the room; Stimulate for 60 seconds/stop for 10 seconds; The duration of stimulation is correlated with the duration of surgery, and taVNS stimulation is performed.

Intervention code:

组别:

假刺激组

样本量:

64

Group:

Sham Group

Sample size:

干预措施:

术前及术中均同干预组相同位置放置电极而行假刺激(术前启动taVNS让患者感受到刺激后立即调整刺激幅度为 0;术中仅放置不启动)

干预措施代码:

Intervention:

Both preoperative and intraoperative, electrodes were placed at the same position as the intervention group for sham stimulation (preoperative activation of taVNS allowed patients to feel the stimulation and immediately adjusted the stimulation amplitude to 0); Intraoperative placement without activation

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆 

市(区县):

重庆 

Country:

China 

Province:

Chongqing 

City:

 

单位(医院):

重庆医科大学附属第一医院  

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术中标准化单位时间单位体重镇痛药物剂量

指标类型:

次要指标

Outcome:

Standardized Body-weight-adjusted 18 Analgesic Dose,SBAD

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后活动状态NRS评分

指标类型:

次要指标

Outcome:

Postoperative activity status NRS score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后12小时时间加权疼痛评分差值和

指标类型:

主要指标

Outcome:

Sum of Pain Intensity Differences 12, SPID 12

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

taVNS 不良反应发生情况

指标类型:

副作用指标

Outcome:

Occurrence of adverse reactions in taVNS

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后24小时时间加权疼痛评分差值和

指标类型:

次要指标

Outcome:

Sum of Pain Intensity Differences 24,SPID 24

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后静息状态NRS评分

指标类型:

次要指标

Outcome:

Postoperative resting state NRS score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后(48h)补救镇痛药物消耗量

指标类型:

次要指标

Outcome:

Postoperative (48h) consumption of remedial analgesic drugs

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后 24 小时疼痛强度-时间曲线下面积

指标类型:

次要指标

Outcome:

Area Under the Pain Intensity-Time Curve,AUPITC 24

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 65 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由独立研究者采用分层区组随机化:按术前医院焦虑抑郁量表中文版(Hospital Anxiety and Depression Scale-Chinese Version,HADS-C)(≥8分/≤7分)分层后,每层内由独立统计者生成区组长度4的区组随机序列,按1∶1比例分配至试验组或对照组,确保每组样本量均衡。

Randomization Procedure (please state who generates the random number sequence and by what method):

Independent researchers used stratified block randomization: after stratification according to the Chinese version of the Hospital Anxiety and Depression Scale Chinese Version (HADS-C) (≥ 8 points/≤ 7 points), independent statisticians generated a block length 4 block random sequence within each layer, which was allocated to the experimental group or control group in a 1:1 ratio to ensure a balanced sample size in each group.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

单盲(对受试者隐藏分组),对评估者不隐藏分组

Blinding:

Single blind (hidden grouping for subjects), no hidden grouping for evaluators

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表,电子采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Report Form and Electronic Data Capture

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-11-28 08:48:40