TEAS通过脑-肠轴改善腹部手术患者术后胃肠功能紊乱

注册号:

Registration number:

ChiCTR1900023263 

最近更新日期:

Date of Last Refreshed on:

2019-11-11 16:50:10 

注册时间:

Date of Registration:

2019-05-19 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

TEAS通过脑-肠轴改善腹部手术患者术后胃肠功能紊乱

Public title:

TEAS improves postoperative gastrointestinal dysfunction through brain-gut axis for patients undergoing abdominal surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

TEAS通过脑-肠轴改善腹部手术患者术后胃肠功能紊乱

Scientific title:

TEAS improves postoperative gastrointestinal dysfunction through brain-gut axis for patients undergoing abdominal surgery

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:

高超 

研究负责人:

安立新 

Applicant:

Chao Gao 

Study leader:

Lixin An 

申请注册联系人电话:

Applicant telephone:

+86 15313883892

研究负责人电话:

Study leader's
telephone:

+86 13810248120

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:

1914244571@qq.com

研究负责人电子邮件:

Study leader's E-mail:

anlixin8120@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:

北京市西城区永安路95号北京友谊医院麻醉科

研究负责人通讯地址:

北京市西城区永安路95号北京友谊医院麻醉科

Applicant address:

95 Yong'an Road, Xicheng District, Beijing, China

Study leader's address:

95 Yong'an Road, Xicheng District, Beijing, China

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:

100050

申请人所在单位:

北京市回民医院

Applicant's institution:

Beijing Huimin Hospital

研究负责人所在单位:

首都医科大学附属北京友谊医院

Affiliation of the Leader:

Beijing Friendship Hospital, Capital Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2019-P2-065-01

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:

首都医科大学附属北京友谊医院生命伦理委员会

Name of the ethic committee:

Bioethics Committee of Beijing Friendship Hospital affiliated to Capital Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2019-04-29 00:00:00

伦理委员会联系人:

崔焱

Contact Name of the ethic committee:

Cuiyan

伦理委员会联系地址:

北京市西城区永安路95号北京友谊医院

Contact Address of the ethic committee:

Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 010-63139017

伦理委员会联系人邮箱:

Contact email of the ethic committee:

13661202501@163.com

研究实施负责(组长)单位:

首都医科大学附属北京友谊医院

Primary sponsor:

Beijing Friendship Hospital, Capital Medical University

研究实施负责(组长)单位地址:

北京市西城区永安路95号北京友谊医院麻醉科

Primary sponsor's address:

95 Yong'an Road, Xicheng District, Beijing, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京

市(区县):

北京

Country:

China

Province:

Beijing

City:

Beijing

单位(医院):

首都医科大学附属北京友谊医院

具体地址:

北京市西城区永安路95号

Institution
hospital:

Beijing Friendship Hospital, Capital Medical University

Address:

95 Yongan Road, Xicheng District, Beijing

经费或物资来源:

自筹

Source(s) of funding:

Self-raising

研究疾病:

术后胃肠功能紊乱  

Target disease:

Postoperative gastrointestinal dysfunction

研究疾病代码:

Target disease code:

研究类型:

预防性研究

Study type:

Prevention

研究所处阶段:

治疗新技术临床试验 

Study phase:

New Treatment Measure Clinical Study

研究设计:

病例对照研究 

Study design:

Case-Control study 

研究目的:

1) 通过围术期应用电针降低PGD的发生证实电针对腹部手术患者术后胃肠功能恢复的有效性。 2) 通过围术期脑肠肽等体内物质的变化,从机理上证实电针对胃肠功能的调节可能通过脑肠轴发挥其作用。 3) 通过卫生学指标(住院时间、住院花费)等进一步证实围术期电针对腹部手术患者术后胃肠功能恢复的意义,为下一步将围术期电刺激有效穴位加入到胃肠手术ERAS的环节中来,提供直接的临床证据。  

Objectives of Study:

1) Confirming the effectiveness of transcutaneous electrical acupuncture (TEAS) on the recovery of postoperative gastrointestinal function in patients undergoing abdominal surgery through reducing the incidence of PGD after usage of TEAS; 2) Through the changes of brain-gut peptide, confirming the mechanism of the effects of TEAS on gastrointestinal function, try to demonstrate that TEAS may play its role through the brain-gut axis; 3) Further confirm the significance of recovery of gastrointestinal function in patients undergoing abdominal surgery through hygienic indicators (hospitalization time, hospitalization cost), etc., in condition to provide direct clinical evidence to add the perioperative electrical stimulation effective acupuncture points to gastrointestinal surgery ERAS for the next step.

药物成份或治疗方案详述:

本研究计划入组280例。按照胃、结直肠肿瘤1:2的比例进行分层,因此,纳入胃肿瘤切除术的患者100例(每组50例),结直肠肿瘤切除术的患者180例(每组90例)。 Ⅰ组(假穴位对照组140例。胃部手术50例,肠道手术90例):选择双侧“神门”上7寸、9寸、外1寸。“昆仑”上 9寸, 12寸做为假穴位对照, 贴上带导线的自粘电极,用两根导线分别连接韩式穴位神经刺激仪(HANS 200A,南京济生医疗科技有限公司生产),不通电给予刺激,模拟脉冲刺激,电刺激时间为术前30min直至手术结束及术后第1天和第2天。术后第一天、术后第二天、第三天上午9:00再次给予模拟刺激,每次刺激30min。直至患者自主排气恢复。 Ⅱ组(TEAS组,140例。胃部手术50例,肠道手术90例):选择双侧“合谷”、“内关”、“足三里”、“上巨虚”, 贴上带导线的自粘电极,用两根导线分别连接韩式穴位神经刺激仪(HANS 200A,南京济生医疗科技有限公司生产),频率2/100HZ,疏密波,每3秒钟交替一次,波宽2Hz时是0.6ms,100Hz时是0.2ms,完全对称双向脉冲波,刺激强度以病人最大耐受程度为宜,电刺激时间为术前30min直至手术结束。刺激时间为麻醉诱导开始至手术结束及术后第1天和第2天。术后第一天、术后第二天、第三天上午9:00再次给予TEAS刺激,每次刺激30min。直至患者自主排气恢复。 

Description for medicine or protocol of treatment in detail:

Group I (Sham acupoint control group, N=140, 50 cases of gastric operation and 90 cases of intestinal operation). Acupoints: 7 inches, 9 inches and 1 inch outside the "Shenmen" on both sides were selected. "Kunlun" 9-inch and 12-inch as the sham acupoints. At the site of acupoints, we attached with self-adhesive electrodes with wires, connected with HANS Acupoint Nerve Stimulator (HANS 200A, produced by Nanjing Jisheng Medical Science and Technology Co., Ltd.) with two wires respectively, without electric stimulation, simulated impulse stimulation, the time of electric stimulation was 30 minutes before operation until the end of operation. Simulated stimulation is given again at 9:00 a.m. on the first day, the second day and the third day after operation, 30 minutes each time. Until the patient recovers from spontaneous faltus. Group II (TEAS group, N=140, 50 cases of gastric operation and 90 cases of intestinal operation). Acupoints: bilateral "Hegu", "Neiguan", "Zusanli", "Shangjuxu" were selected, self-adhesive electrodes with wires were attached, and HANS acupoint nerve stimulator (HANS 200A, produced by Nanjing Jisheng Medical Technology Co., Ltd.) was connected with two wires respectively. The frequency was 2/100HZ, sparse wave was alternated every 3 seconds, and the wave width was 0.6ms at 2Hz. The best stimulation intensity is patient's maximum tolerance. The time of electrical stimulation is 30 minutes before operation until the end of operation. The stimulation time was from the beginning of anesthesia induction to the end of operation. TEAS is given again at 9:00 a.m. on the first day, the second day and the third day after operation, 30 minutes each time. Until the patient recovers from spontaneous flatus. 

纳入标准:

Inclusion criteria

排除标准:

(1)合谷/内关/上巨虚/足三里所在经络有手术切口或手术瘢痕;
(2)经穴局部有皮肤感染的患者;
(3)有上肢或者下肢神经损伤的患者;
(4)有脊柱手术史;
(5)近四周内参加过其它临床试验患者;
(6)不能理解VAS评分与NRS评分,不会使用PCA的患者;
(7)应用起搏器患者;
(8)孕妇、产妇、尿妊娠试验阳性的患者;
(9)术前合并疼痛,正在使用中枢性镇痛药物的患者,阿片类药物成瘾、依赖者;
(10)术前合并严重的中枢神经系统疾病及严重精神疾病;
(11)所行手术需要进行肠造瘘;
(12)有酗酒史的患者;
(13)术后需转入ICU进行治疗的患者;
(14)研究者认为不适合参加本次研究的患者;

Exclusion criteria:

(1) There are surgical incisions or surgical scars in the meridians of Hegu/Neiguan/Shangjuxu/Zusanli;
(2) Patients with skin infections in the acupoints;
(3) Patients with upper or lower limb nerve damage;
(4) History of spinal surgery;
(5) Patients who have participated in other clinical trials in the past four weeks;
(6) Patients who do not understand VAS scores and NRS scores and do not use PCA;
(7) Applying a pacemaker patient;
(8) pregnant women, maternal, and urine pregnancy test positive patients;
(9) patients with combined pain before surgery, patients who are taking central analgesic drugs, opioid addiction, dependents;
(10) Preoperative combination of severe central nervous system diseases and severe mental illness;
(11) The operation required for enteral fistula;
(12) Patients with a history of alcohol abuse;
(13) Patients who need to be transferred to the ICU for treatment after surgery;
(14) Patients considered by the investigator to be unfit to participate in the study.

研究实施时间:

Study execute time:

From 2019-07-01 00:00:00 To 2021-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2019-09-01 00:00:00 To 2021-07-30 00:00:00

干预措施:

Interventions:

组别:

Ⅰ组

样本量:

140

Group:

Group I

Sample size:

干预措施:

假穴位对照

干预措施代码:

Intervention:

Sham points control group

Intervention code:

组别:

II组

样本量:

140

Group:

Group II

Sample size:

干预措施:

TEAS组

干预措施代码:

Intervention:

TEAS group

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

首都医科大学附属北京友谊医院 

单位级别:

三甲医院 

Institution
hospital:

Beijing Friendship Hospital, Capital Medical University

Level of the institution:

Tertiary A Hospital

测量指标:

Outcomes:

指标中文名:

肛门排气时间

指标类型:

主要指标

Outcome:

time to first flatus

Type:

Primary indicator

测量时间点:

术后

测量方法:

患者自查报告

Measure time point of outcome:

Postoperative day

Measure method:

Participant questionnaires filled out once daily

指标中文名:

首次肠鸣音恢复时间

指标类型:

主要指标

Outcome:

time to first bowel motion

Type:

Primary indicator

测量时间点:

术后

测量方法:

医生定期检查并听诊

Measure time point of outcome:

Postoperative day

Measure method:

Doctors check and auscultate regularly

指标中文名:

排便时间

指标类型:

主要指标

Outcome:

time to defecation

Type:

Primary indicator

测量时间点:

术后

测量方法:

患者自查报告

Measure time point of outcome:

Postoperative day

Measure method:

participant questionnaires filled out once daily

指标中文名:

5-HT

指标类型:

主要指标

Outcome:

5-HT

Type:

Primary indicator

测量时间点:

术前、术后1天、术后3天

测量方法:

血清

Measure time point of outcome:

Preoperative, 1 day and 3 days after operation

Measure method:

Serum

指标中文名:

SP

指标类型:

主要指标

Outcome:

SP

Type:

Primary indicator

测量时间点:

术前、术后1天、术后3天

测量方法:

血清

Measure time point of outcome:

Preoperative, 1 day and 3 days after operation

Measure method:

serum

指标中文名:

血管活性多肽

指标类型:

主要指标

Outcome:

VIP

Type:

Primary indicator

测量时间点:

术前、术后1天、术后3天

测量方法:

血清

Measure time point of outcome:

Preoperative, 1 day and 3 days after operation

Measure method:

serum

指标中文名:

胃泌素

指标类型:

主要指标

Outcome:

gastrin

Type:

Primary indicator

测量时间点:

术前、术后1天、术后3天

测量方法:

血清

Measure time point of outcome:

Preoperative,1 day and 3 days after surgery

Measure method:

serum

指标中文名:

胆囊收缩素

指标类型:

主要指标

Outcome:

CCK

Type:

Primary indicator

测量时间点:

术前、术后1天、术后3天

测量方法:

血清

Measure time point of outcome:

Preoperative, 1 day and 3days after surgery

Measure method:

serum

指标中文名:

住院时间

指标类型:

次要指标

Outcome:

Length of hospital stay

Type:

Secondary indicator

测量时间点:

出院时

测量方法:

从手术当日到出院、转院或死亡时间

Measure time point of outcome:

Discharge

Measure method:

the number of days from the date of colorectal resection to the date of discharge, transfer or death

指标中文名:

住院死亡率

指标类型:

次要指标

Outcome:

hospital mortality

Type:

Secondary indicator

测量时间点:

死亡时

测量方法:

死亡率

Measure time point of outcome:

The date of dead

Measure method:

hospital mortality

指标中文名:

住院花费

指标类型:

次要指标

Outcome:

Hospitalization expenses

Type:

Secondary indicator

测量时间点:

出院

测量方法:

Measure time point of outcome:

Discharge

Measure method:

指标中文名:

术后并发症

指标类型:

次要指标

Outcome:

postoperative clinical complications such as vomiting, fever, pneumonia, wound infection, and bleeding.

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:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

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 70 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):

本研究按照分层随机的方法。根据患者的手术种类进入两层:胃肿瘤切除术组,结直肠肿瘤切除术组。再在每一层,根据计算机自动生成的随机数字表格中的数字,其对应的分组信息进行随机分组。

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

This study is based on stratified random method. According to the type of operation, the patients were divided into two groups: gastric cancer resection group and colorectal cancer resection group. At each level, the corresponding grouping information is grouped randomly according to the number in the random nu

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

本研究的盲法为,患者盲、结局指标的术后随访者(化验检查的人员)盲,而负责进行TEAS操作的医生不盲的方法。

Blinding:

The blindness method in this study is that the patients are blind, follow-up (laboratory examiners) of patients with blindness and outcome indicators are blind, while the doctors responsible for TEAS operation are not blind.

是否共享原始数据:

IPD sharing

是Yes

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):

本研究结束后6个月内,可采用邮件联系的方式共享原始数据。Email:anlixin8120@163.com

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

Within 6 months after the end of this study, the original data can be shared through email contact. Email:anlixin8120@163.com

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:

1. 病例报告表 2. 电子版录入原始数据

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

1. Case Record Form, CRF. 2. Electrical input of datas.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2019-05-19 13:58:50