RESUMEN

BACKGROUND: Postprandial distress syndrome (PDS) is referred to as meal-related functional dyspepsia (FD) and causes a reduced quality of life (QoL) for patients. Several randomized controlled trials (RCTs) have suggested that acupuncture is an effective treatment for FD, but few studies were particularly for PDS. This pilot study was designed to determine the feasibility and efficacy of acupuncture in patients with PDS characterized by postprandial fullness and early satiation according to the Rome III criteria. METHODS: This is a multi-center, two-arm, blinded (participants), pilot RCT. Forty-two participants who meet the inclusion criteria will be randomly assigned to the verum acupuncture group or minimal acupuncture group in a 1:1 ratio. Both treatments consist of 12 sessions of 20 min duration over four weeks (three sessions per week). The primary outcome measurement is the proportion of persons who improve as assessed using the global outcome by the overall treatment effect (OTE) at end-of-treatment (EOT) (four weeks after randomization). Global assessment at weeks 8 and 16 after randomization is one of the secondary outcomes. The other secondary outcomes including symptoms, disease-specific QoL, and depression and anxiety will be assessed at weeks 4, 8, and 16 after randomization. DISCUSSION: This pilot study will help determine the feasibility and efficacy of acupuncture in patients with PDS. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN18135146 . Registered on 7 July 2016.

Asunto(s)

Terapia por Acupuntura , Dispepsia/terapia , Periodo Posprandial , Terapia por Acupuntura/efectos adversos , Adolescente , Adulto , Anciano , China , Protocolos Clínicos , Dispepsia/diagnóstico , Dispepsia/etiología , Dispepsia/fisiopatología , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Calidad de Vida , Recuperación de la Función , Proyectos de Investigación , Encuestas y Cuestionarios , Síndrome , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven

RESUMEN

OBJECTIVE: To observe the kinetic change that reflects joint loading in different planes during stair climbing in knee osteoarthritis (KOA) after electroacupuncture (EA) by three-dimensional motion analysis, so as to provide reference for its biomechanical mechanism treated with acupuncture. METHODS: Forty KOA patients, in accordance with the random number table, were assigned into an observation group and a control group, 20 cases in each one and finally 18 cases completed. Acupoints in the observation group were Neixiyan (EX-LE 4), Dubi (ST 35), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Liangqiu (ST 34) and Zusanli (ST 36); points in the control groups were located about 2 cm next to the above acupoints with shallow acupuncture. EA was connected at Neixiyan (EX-LE 4) and Yinlingquan (SP 9), Liangqiu (ST 34) and Yanglingquan (GB 34). The frequency was 2 Hz with continuous wave in the observation group and there was no current in the control group for the corresponding points. All the treatment was given for 3 weeks, totally 11 times. Climbing stairs gait was measured before and after treatment. Velocities and kinetic parameters during ascending and descending stairs were analyzed, including flexion and extension peak torques of hip, knee, ankle on the vertical plane, external knee adduction moment on the coronal plane. RESULTS: After treatment in the observation group, velocities during ascending and descending stairs significantly increased (P<0.05, P<0.01); maximal ankle plantar flexor moments during ascending and descending stairs and the second peak external knee adduction moment (PEKAM2) during ascending stairs significantly increased (P<0.05, P<0.01). After treatment in the control group, the first peak external knee adduction moment (PEKAM1) and PEKAM2 during descending stairs were less than those before treatment (P<0.05, P<0.01). In the observation group, the difference value (DV) of velocity before and after treatment was positively correlated to DV in the torque of ankle plantar flexors during ascending stairs in the observation group (r=0.598，P<0.01). Excluding the impact of velocity, the DV of the maximal torque of ankle plantar flexors during ascending stairs didn't show difference in the observation group (P>0.05). CONCLUSION: EA can increase the velocities of ascending and descending stairs of KOA patients. It improves the loading capacity of knee joint on both sagittal and coronary planes. But its effect during ascending may be correlated with the increase of velocity. The mechanism of different effects between EA and minimal acupuncture on joint moments is still unclear and warrants further study.

Asunto(s)

Electroacupuntura/métodos , Osteoartritis de la Rodilla/terapia , Subida de Escaleras/fisiología , Puntos de Acupuntura , Fenómenos Biomecánicos , Humanos , Articulación de la Rodilla , Osteoartritis de la Rodilla/fisiopatología

RESUMEN

<p><b>OBJECTIVE</b>To observe the kinetic change that reflects joint loading in different planes during stair climbing in knee osteoarthritis (KOA) after electroacupuncture (EA) by three-dimensional motion analysis, so as to provide reference for its biomechanical mechanism treated with acupuncture.</p><p><b>METHODS</b>Forty KOA patients, in accordance with the random number table, were assigned into an observation group and a control group, 20 cases in each one and finally 18 cases completed. Acupoints in the observation group were Neixiyan (EX-LE 4), Dubi (ST 35), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Liangqiu (ST 34) and Zusanli (ST 36); points in the control groups were located about 2 cm next to the above acupoints with shallow acupuncture. EA was connected at Neixiyan (EX-LE 4) and Yinlingquan (SP 9), Liangqiu (ST 34) and Yanglingquan (GB 34). The frequency was 2 Hz with continuous wave in the observation group and there was no current in the control group for the corresponding points. All the treatment was given for 3 weeks, totally 11 times. Climbing stairs gait was measured before and after treatment. Velocities and kinetic parameters during ascending and descending stairs were analyzed, including flexion and extension peak torques of hip, knee, ankle on the vertical plane, external knee adduction moment on the coronal plane.</p><p><b>RESULTS</b>After treatment in the observation group, velocities during ascending and descending stairs significantly increased (<0.05,<0.01); maximal ankle plantar flexor moments during ascending and descending stairs and the second peak external knee adduction moment (PEKAM2) during ascending stairs significantly increased (<0.05,<0.01). After treatment in the control group, the first peak external knee adduction moment (PEKAM1) and PEKAM2 during descending stairs were less than those before treatment (<0.05,<0.01). In the observation group, the difference value (DV) of velocity before and after treatment was positively correlated to DV in the torque of ankle plantar flexors during ascending stairs in the observation group (=0.598，<0.01). Excluding the impact of velocity, the DV of the maximal torque of ankle plantar flexors during ascending stairs didn't show difference in the observation group (>0.05).</p><p><b>CONCLUSION</b>EA can increase the velocities of ascending and descending stairs of KOA patients. It improves the loading capacity of knee joint on both sagittal and coronary planes. But its effect during ascending may be correlated with the increase of velocity. The mechanism of different effects between EA and minimal acupuncture on joint moments is still unclear and warrants further study.</p>