Transcutaneous Electrical Acustimulation Improves Gastrointestinal Disturbances Induced by Transcatheter Arterial Chemoembolization in Patients With Liver Cancers
Background Gastrointestinal (GI) disturbances occur in patients who receive chemotherapy via transcatheter arterial chemoembolization (TACE) and could last for an extended period of time in some cases. Antiemetic drugs have a potential risk of developing hepatic failure and are ineffective for delay...
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| Veröffentlicht in: | Neuromodulation (Malden, Mass.) Mass.), 2020-12, Vol.23 (8), p.1180-1188 |
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| creator | Zhu, Ying Li, Xianpeng Ma, Jibo Xu, Wenyi Li, Miaomiao Gong, Yaoyao Zhang, Bo Chen, Ying Chao, Sun Xu, Qingcheng Lin, Lin Chen, Jiande D.Z. |
| description | Background
Gastrointestinal (GI) disturbances occur in patients who receive chemotherapy via transcatheter arterial chemoembolization (TACE) and could last for an extended period of time in some cases. Antiemetic drugs have a potential risk of developing hepatic failure and are ineffective for delayed nausea and emesis. Transcutaneous electrical acustimulation (TEA) has recently been reported to exert antiemetic and prokinetic effects, but it is unknown whether it has an ameliorating effect on TACE‐induced GI disturbances.
Aim
This study was designed to evaluate effects and mechanisms of noninvasive TEA on GI symptoms in patients treated with TACE.
Materials and Methods
Seventy‐four patients with liver cancers (eighteen female; age 63.4 ± 1.1 years) scheduled for TACE were randomized to TEA (n = 37) or sham‐TEA (n = 37). TEA was performed via acupoints, ST36 and PC6 using parameters previously optimized for GI motility (1 h, bid) from the postoperative day 0 (POD0) to POD2. Sham‐TEA was performed using the same parameters via non‐acupoints. Symptom questionnaires were completed daily. The electrogastrogram (EGG) and electrocardiogram (ECG) were recorded in the fasting state for 30 mins to assess gastric slow waves and autonomic functions, respectively, before and after the 3‐day treatment.
Results
1) In the acute phase (24 h), TEA, compared with sham‐TEA, decreased the percentage of patients who experienced nausea on POD3 (0% vs. 13.5%, p = 0.021), the nausea score on POD3 (p = 0.022), the anorexia score on POD2 (p = 0.040) and POD3 (p = 0.004), and the bloating score (POD1‐3: p |
| doi_str_mv | 10.1111/ner.13158 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2399831697</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2472149947</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-db9a2dc592805fe1bdf1470320935d457f4eaec3ddd9a28e589039aa3127060a3</originalsourceid><addsrcrecordid>eNp1kctu1DAUhi0EohdY8ALIEhu6SOtLPI6Xo-lQRhrRChWxjBz7ROMqcYovRcPj8KR4SNsFEl7YRzqfP-mcH6F3lJzTci48hHPKqWheoGMqmKhoTfjLUhNVV5IKdYROYrwjhErF5Gt0xBmXDVvQY_T7NmgfTU7aw5QjXg9gUnBGD3hpckxuzINObvJ4M96H6QEivtIxhcn5BKXtC3jpYsqh096U7sbbbMDibo9ntU47SBDwMpTbFXy1g3GCsZsG92tWO49vSgU-RfzdpR3euofyY3UwhvgGver1EOHt43uKvn1a364-V9vrq81qua0MF7ypbKc0s0Yo1hDRA-1sT2tJOCOKC1sL2degwXBrbQEbEI0iXGnNKZNkQTQ_RR9nb5nzRy7DtaOLBoZhXk3LuFINpwslC_rhH_RuyqHsolC1ZLRWqj5QZzNlwhRjgL69D27UYd9S0h6Ca0tw7d_gCvv-0Zi7Eewz-ZRUAS5m4KcbYP9_U_tl_XVW_gGN7KYQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2472149947</pqid></control><display><type>article</type><title>Transcutaneous Electrical Acustimulation Improves Gastrointestinal Disturbances Induced by Transcatheter Arterial Chemoembolization in Patients With Liver Cancers</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Zhu, Ying ; Li, Xianpeng ; Ma, Jibo ; Xu, Wenyi ; Li, Miaomiao ; Gong, Yaoyao ; Zhang, Bo ; Chen, Ying ; Chao, Sun ; Xu, Qingcheng ; Lin, Lin ; Chen, Jiande D.Z.</creator><creatorcontrib>Zhu, Ying ; Li, Xianpeng ; Ma, Jibo ; Xu, Wenyi ; Li, Miaomiao ; Gong, Yaoyao ; Zhang, Bo ; Chen, Ying ; Chao, Sun ; Xu, Qingcheng ; Lin, Lin ; Chen, Jiande D.Z.</creatorcontrib><description>Background
Gastrointestinal (GI) disturbances occur in patients who receive chemotherapy via transcatheter arterial chemoembolization (TACE) and could last for an extended period of time in some cases. Antiemetic drugs have a potential risk of developing hepatic failure and are ineffective for delayed nausea and emesis. Transcutaneous electrical acustimulation (TEA) has recently been reported to exert antiemetic and prokinetic effects, but it is unknown whether it has an ameliorating effect on TACE‐induced GI disturbances.
Aim
This study was designed to evaluate effects and mechanisms of noninvasive TEA on GI symptoms in patients treated with TACE.
Materials and Methods
Seventy‐four patients with liver cancers (eighteen female; age 63.4 ± 1.1 years) scheduled for TACE were randomized to TEA (n = 37) or sham‐TEA (n = 37). TEA was performed via acupoints, ST36 and PC6 using parameters previously optimized for GI motility (1 h, bid) from the postoperative day 0 (POD0) to POD2. Sham‐TEA was performed using the same parameters via non‐acupoints. Symptom questionnaires were completed daily. The electrogastrogram (EGG) and electrocardiogram (ECG) were recorded in the fasting state for 30 mins to assess gastric slow waves and autonomic functions, respectively, before and after the 3‐day treatment.
Results
1) In the acute phase (<24 h), TEA showed no effects on any of GI symptoms, compared with sham‐TEA. 2) In the delayed phase (>24 h), TEA, compared with sham‐TEA, decreased the percentage of patients who experienced nausea on POD3 (0% vs. 13.5%, p = 0.021), the nausea score on POD3 (p = 0.022), the anorexia score on POD2 (p = 0.040) and POD3 (p = 0.004), and the bloating score (POD1‐3: p < 0.01). 3) In comparison with sham‐TEA, TEA increased the number of spontaneous bowel movements (p = 0.001) and the Bristol score of the first stool (p = 0.014) and decreased the number of patients with the use of laxatives (p = 0.022). 4) Physiologically, the 3‐day TEA but not sham‐TEA increased the percentage of normal gastric slow waves (p < 0.001) and vagal activity (p = 0.006). The vagal activity was negatively correlated with the anorexia score (r = −0.267, p = 0.026). It was found that the sympathovagal ratio and tumor size>5 cm were independent risk factors predicting the occurrence of nausea in patients after TACE.
Conclusion
TEA improves major TACE‐induced GI disturbances in the delayed phase, including nausea, bloating, impaired gastric pace‐making activity, and constipation in patients with liver cancers via the autonomic pathway.</description><identifier>ISSN: 1094-7159</identifier><identifier>EISSN: 1525-1403</identifier><identifier>DOI: 10.1111/ner.13158</identifier><identifier>PMID: 32378261</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Anorexia ; Carcinoma, Hepatocellular - therapy ; Chemoembolization ; Chemoembolization, Therapeutic - adverse effects ; Chemotherapy ; Constipation ; EKG ; Electrical stimulation ; Electroacupuncture ; Female ; Gastrointestinal Motility ; Humans ; Intestine ; Laxatives ; Liver cancer ; Liver Neoplasms - therapy ; Middle Aged ; Nausea ; neuromodulation ; Risk factors ; Stomach ; transcatheter arterial chemoembolization ; Vagus nerve ; Vomiting</subject><ispartof>Neuromodulation (Malden, Mass.), 2020-12, Vol.23 (8), p.1180-1188</ispartof><rights>2020 International Neuromodulation Society</rights><rights>2020 International Neuromodulation Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-db9a2dc592805fe1bdf1470320935d457f4eaec3ddd9a28e589039aa3127060a3</citedby><cites>FETCH-LOGICAL-c3538-db9a2dc592805fe1bdf1470320935d457f4eaec3ddd9a28e589039aa3127060a3</cites><orcidid>0000-0001-9880-5330</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32378261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Ying</creatorcontrib><creatorcontrib>Li, Xianpeng</creatorcontrib><creatorcontrib>Ma, Jibo</creatorcontrib><creatorcontrib>Xu, Wenyi</creatorcontrib><creatorcontrib>Li, Miaomiao</creatorcontrib><creatorcontrib>Gong, Yaoyao</creatorcontrib><creatorcontrib>Zhang, Bo</creatorcontrib><creatorcontrib>Chen, Ying</creatorcontrib><creatorcontrib>Chao, Sun</creatorcontrib><creatorcontrib>Xu, Qingcheng</creatorcontrib><creatorcontrib>Lin, Lin</creatorcontrib><creatorcontrib>Chen, Jiande D.Z.</creatorcontrib><title>Transcutaneous Electrical Acustimulation Improves Gastrointestinal Disturbances Induced by Transcatheter Arterial Chemoembolization in Patients With Liver Cancers</title><title>Neuromodulation (Malden, Mass.)</title><addtitle>Neuromodulation</addtitle><description>Background
Gastrointestinal (GI) disturbances occur in patients who receive chemotherapy via transcatheter arterial chemoembolization (TACE) and could last for an extended period of time in some cases. Antiemetic drugs have a potential risk of developing hepatic failure and are ineffective for delayed nausea and emesis. Transcutaneous electrical acustimulation (TEA) has recently been reported to exert antiemetic and prokinetic effects, but it is unknown whether it has an ameliorating effect on TACE‐induced GI disturbances.
Aim
This study was designed to evaluate effects and mechanisms of noninvasive TEA on GI symptoms in patients treated with TACE.
Materials and Methods
Seventy‐four patients with liver cancers (eighteen female; age 63.4 ± 1.1 years) scheduled for TACE were randomized to TEA (n = 37) or sham‐TEA (n = 37). TEA was performed via acupoints, ST36 and PC6 using parameters previously optimized for GI motility (1 h, bid) from the postoperative day 0 (POD0) to POD2. Sham‐TEA was performed using the same parameters via non‐acupoints. Symptom questionnaires were completed daily. The electrogastrogram (EGG) and electrocardiogram (ECG) were recorded in the fasting state for 30 mins to assess gastric slow waves and autonomic functions, respectively, before and after the 3‐day treatment.
Results
1) In the acute phase (<24 h), TEA showed no effects on any of GI symptoms, compared with sham‐TEA. 2) In the delayed phase (>24 h), TEA, compared with sham‐TEA, decreased the percentage of patients who experienced nausea on POD3 (0% vs. 13.5%, p = 0.021), the nausea score on POD3 (p = 0.022), the anorexia score on POD2 (p = 0.040) and POD3 (p = 0.004), and the bloating score (POD1‐3: p < 0.01). 3) In comparison with sham‐TEA, TEA increased the number of spontaneous bowel movements (p = 0.001) and the Bristol score of the first stool (p = 0.014) and decreased the number of patients with the use of laxatives (p = 0.022). 4) Physiologically, the 3‐day TEA but not sham‐TEA increased the percentage of normal gastric slow waves (p < 0.001) and vagal activity (p = 0.006). The vagal activity was negatively correlated with the anorexia score (r = −0.267, p = 0.026). It was found that the sympathovagal ratio and tumor size>5 cm were independent risk factors predicting the occurrence of nausea in patients after TACE.
Conclusion
TEA improves major TACE‐induced GI disturbances in the delayed phase, including nausea, bloating, impaired gastric pace‐making activity, and constipation in patients with liver cancers via the autonomic pathway.</description><subject>Anorexia</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Chemoembolization</subject><subject>Chemoembolization, Therapeutic - adverse effects</subject><subject>Chemotherapy</subject><subject>Constipation</subject><subject>EKG</subject><subject>Electrical stimulation</subject><subject>Electroacupuncture</subject><subject>Female</subject><subject>Gastrointestinal Motility</subject><subject>Humans</subject><subject>Intestine</subject><subject>Laxatives</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - therapy</subject><subject>Middle Aged</subject><subject>Nausea</subject><subject>neuromodulation</subject><subject>Risk factors</subject><subject>Stomach</subject><subject>transcatheter arterial chemoembolization</subject><subject>Vagus nerve</subject><subject>Vomiting</subject><issn>1094-7159</issn><issn>1525-1403</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhi0EohdY8ALIEhu6SOtLPI6Xo-lQRhrRChWxjBz7ROMqcYovRcPj8KR4SNsFEl7YRzqfP-mcH6F3lJzTci48hHPKqWheoGMqmKhoTfjLUhNVV5IKdYROYrwjhErF5Gt0xBmXDVvQY_T7NmgfTU7aw5QjXg9gUnBGD3hpckxuzINObvJ4M96H6QEivtIxhcn5BKXtC3jpYsqh096U7sbbbMDibo9ntU47SBDwMpTbFXy1g3GCsZsG92tWO49vSgU-RfzdpR3euofyY3UwhvgGver1EOHt43uKvn1a364-V9vrq81qua0MF7ypbKc0s0Yo1hDRA-1sT2tJOCOKC1sL2degwXBrbQEbEI0iXGnNKZNkQTQ_RR9nb5nzRy7DtaOLBoZhXk3LuFINpwslC_rhH_RuyqHsolC1ZLRWqj5QZzNlwhRjgL69D27UYd9S0h6Ca0tw7d_gCvv-0Zi7Eewz-ZRUAS5m4KcbYP9_U_tl_XVW_gGN7KYQ</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Zhu, Ying</creator><creator>Li, Xianpeng</creator><creator>Ma, Jibo</creator><creator>Xu, Wenyi</creator><creator>Li, Miaomiao</creator><creator>Gong, Yaoyao</creator><creator>Zhang, Bo</creator><creator>Chen, Ying</creator><creator>Chao, Sun</creator><creator>Xu, Qingcheng</creator><creator>Lin, Lin</creator><creator>Chen, Jiande D.Z.</creator><general>John Wiley & Sons, Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9880-5330</orcidid></search><sort><creationdate>202012</creationdate><title>Transcutaneous Electrical Acustimulation Improves Gastrointestinal Disturbances Induced by Transcatheter Arterial Chemoembolization in Patients With Liver Cancers</title><author>Zhu, Ying ; Li, Xianpeng ; Ma, Jibo ; Xu, Wenyi ; Li, Miaomiao ; Gong, Yaoyao ; Zhang, Bo ; Chen, Ying ; Chao, Sun ; Xu, Qingcheng ; Lin, Lin ; Chen, Jiande D.Z.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-db9a2dc592805fe1bdf1470320935d457f4eaec3ddd9a28e589039aa3127060a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anorexia</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Chemoembolization</topic><topic>Chemoembolization, Therapeutic - adverse effects</topic><topic>Chemotherapy</topic><topic>Constipation</topic><topic>EKG</topic><topic>Electrical stimulation</topic><topic>Electroacupuncture</topic><topic>Female</topic><topic>Gastrointestinal Motility</topic><topic>Humans</topic><topic>Intestine</topic><topic>Laxatives</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - therapy</topic><topic>Middle Aged</topic><topic>Nausea</topic><topic>neuromodulation</topic><topic>Risk factors</topic><topic>Stomach</topic><topic>transcatheter arterial chemoembolization</topic><topic>Vagus nerve</topic><topic>Vomiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Ying</creatorcontrib><creatorcontrib>Li, Xianpeng</creatorcontrib><creatorcontrib>Ma, Jibo</creatorcontrib><creatorcontrib>Xu, Wenyi</creatorcontrib><creatorcontrib>Li, Miaomiao</creatorcontrib><creatorcontrib>Gong, Yaoyao</creatorcontrib><creatorcontrib>Zhang, Bo</creatorcontrib><creatorcontrib>Chen, Ying</creatorcontrib><creatorcontrib>Chao, Sun</creatorcontrib><creatorcontrib>Xu, Qingcheng</creatorcontrib><creatorcontrib>Lin, Lin</creatorcontrib><creatorcontrib>Chen, Jiande D.Z.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Neuromodulation (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Ying</au><au>Li, Xianpeng</au><au>Ma, Jibo</au><au>Xu, Wenyi</au><au>Li, Miaomiao</au><au>Gong, Yaoyao</au><au>Zhang, Bo</au><au>Chen, Ying</au><au>Chao, Sun</au><au>Xu, Qingcheng</au><au>Lin, Lin</au><au>Chen, Jiande D.Z.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcutaneous Electrical Acustimulation Improves Gastrointestinal Disturbances Induced by Transcatheter Arterial Chemoembolization in Patients With Liver Cancers</atitle><jtitle>Neuromodulation (Malden, Mass.)</jtitle><addtitle>Neuromodulation</addtitle><date>2020-12</date><risdate>2020</risdate><volume>23</volume><issue>8</issue><spage>1180</spage><epage>1188</epage><pages>1180-1188</pages><issn>1094-7159</issn><eissn>1525-1403</eissn><abstract>Background
Gastrointestinal (GI) disturbances occur in patients who receive chemotherapy via transcatheter arterial chemoembolization (TACE) and could last for an extended period of time in some cases. Antiemetic drugs have a potential risk of developing hepatic failure and are ineffective for delayed nausea and emesis. Transcutaneous electrical acustimulation (TEA) has recently been reported to exert antiemetic and prokinetic effects, but it is unknown whether it has an ameliorating effect on TACE‐induced GI disturbances.
Aim
This study was designed to evaluate effects and mechanisms of noninvasive TEA on GI symptoms in patients treated with TACE.
Materials and Methods
Seventy‐four patients with liver cancers (eighteen female; age 63.4 ± 1.1 years) scheduled for TACE were randomized to TEA (n = 37) or sham‐TEA (n = 37). TEA was performed via acupoints, ST36 and PC6 using parameters previously optimized for GI motility (1 h, bid) from the postoperative day 0 (POD0) to POD2. Sham‐TEA was performed using the same parameters via non‐acupoints. Symptom questionnaires were completed daily. The electrogastrogram (EGG) and electrocardiogram (ECG) were recorded in the fasting state for 30 mins to assess gastric slow waves and autonomic functions, respectively, before and after the 3‐day treatment.
Results
1) In the acute phase (<24 h), TEA showed no effects on any of GI symptoms, compared with sham‐TEA. 2) In the delayed phase (>24 h), TEA, compared with sham‐TEA, decreased the percentage of patients who experienced nausea on POD3 (0% vs. 13.5%, p = 0.021), the nausea score on POD3 (p = 0.022), the anorexia score on POD2 (p = 0.040) and POD3 (p = 0.004), and the bloating score (POD1‐3: p < 0.01). 3) In comparison with sham‐TEA, TEA increased the number of spontaneous bowel movements (p = 0.001) and the Bristol score of the first stool (p = 0.014) and decreased the number of patients with the use of laxatives (p = 0.022). 4) Physiologically, the 3‐day TEA but not sham‐TEA increased the percentage of normal gastric slow waves (p < 0.001) and vagal activity (p = 0.006). The vagal activity was negatively correlated with the anorexia score (r = −0.267, p = 0.026). It was found that the sympathovagal ratio and tumor size>5 cm were independent risk factors predicting the occurrence of nausea in patients after TACE.
Conclusion
TEA improves major TACE‐induced GI disturbances in the delayed phase, including nausea, bloating, impaired gastric pace‐making activity, and constipation in patients with liver cancers via the autonomic pathway.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32378261</pmid><doi>10.1111/ner.13158</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9880-5330</orcidid></addata></record> |
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| ispartof | Neuromodulation (Malden, Mass.), 2020-12, Vol.23 (8), p.1180-1188 |
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| subjects | Anorexia Carcinoma, Hepatocellular - therapy Chemoembolization Chemoembolization, Therapeutic - adverse effects Chemotherapy Constipation EKG Electrical stimulation Electroacupuncture Female Gastrointestinal Motility Humans Intestine Laxatives Liver cancer Liver Neoplasms - therapy Middle Aged Nausea neuromodulation Risk factors Stomach transcatheter arterial chemoembolization Vagus nerve Vomiting |
| title | Transcutaneous Electrical Acustimulation Improves Gastrointestinal Disturbances Induced by Transcatheter Arterial Chemoembolization in Patients With Liver Cancers |
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