Clinical Study On The Clinical Efficacy And Constipation And Emotional Correlation Of Electroacupuncture In Severe Functional Constipation

Objective1 To evaluate and confirm the effectiveness of electroacupuncture needling method for treating severe functional constipation through clinical randomized controlled trials.2 To analyze changes of emotional when severe functional constipation.Methods1 Literature reviewThrough the ancient and modern literature retrieval on acupuncture treatment of constipation,to understand the situation of deep needling and electroacupuncture treatment on functional constipation.Through the ancient and modern literature retrieval onconstipation and emotional,to discuss the relevance of them.2 Clinical studies2.1 Grouping70 cases of severe functional constipation in accordance with the inclusive criteria were randomly divided into treatment group (Electroacupuncture group,EA) and control group (sham EAgroup, shamEA),35 cases in each group.2.2 Treatment method2.2.1 The treatment group (Electroacupuncture group,EA)Acupoints:(bilaterally) Tianshu (ST25),Fujie (SP14),Shangjuxu (ST37).Manipulation Methods:For Tianshu (ST25) and Fujie (SP14),3 inch stainless steel needles were adopted to insert skin quickly,and then slowly vertical deep needling, until the parietal peritoneum,no insertion and twisting.Then the needle handles of the above points were horizontally and bilaterally connected to the electrodes of the electroacupuncture device.The device is adjusted according to the following standard: Asparse-dense wave should be applied,with a frequency of 15Hz and a current intensity between 0.1mA-1.0mAuntil the abdominal muscle vibrates slightly. For Shangjuxu (ST37), filiform needles (1.5 inch) were vertically inserted 1 inch, then slightly and uniformly lifted and thrusted three times until Deqi (thedesired sensation). During the retaining needle period, the needles were manipulated every 10 minutes. Totally there are three times.The course and the duration of treatment:the duration of 30 minutes are recommended for each treatment. And the course which is 5 times per week in the first two weeks and 3 times per week in the rest 6 weeks are recommended, namely 8 weeks and 28 times of treatment in total.2.2.2 The control group (sham EAgroup, ShamEA) Acupoints:The non-acupoints located beside the bilateral Tianshu (ST25),Fujie (SP14) and Shangjuxu (ST37),which are respectively described as next-to-Tianshu (ST25), next-to-Fujie (SP14),next-to-Shangjuxu (ST37) in the following content.Location:The next-to-Tianshu (ST25) is 1 cun lateral to Tianshu (ST25), in the middle point of line linking the Spleen and the Stomach meridian. The next-to-Fujie (SP14) is 1 cun lateral to the Fujie (SP14),also in the middle point of the line linking the Spleen and the Stomach meridian.The next-to-Shangjuxu (ST37) is lateral to the Shangjuxu (ST37),in the middle point of the line linking the Gallbladder and the Stomach meridian.One inch stainless steel needles were adopted to insert 0.3-0.5 inch, no insertion and twisting.The needle handles of both points were connected to the special electrodes of the electroacupuncture device.The frequency and the current intensity are respectively set as 15Hz and 0.5mA.Special electric wires were made for this group, in the middle of which were cut while they look the same as the normal ones. That is to say, although the device is turned on, indicating a successful connection,there is actually no electricity through the wire.The frequency and the course of the treatment are the same as the treatment group.Patients are informed that effective and slight current is put in, which may hardly feel by the body,but it is really put out by the device.2.3 Observation Indicators2.3.1 Constipation curative effect2.3.1.1 Spontaneous Bowel Movements (SBM):Compared to the baseline,the average of weekly SBM increased during the period of 4 weeks treatment and 8 weeks treatment.2.3.1.2 Defecate Difficulty:Compared to the baseline,the average of weekly increase or decrease during the period of 4 weeks treatment and 8 weeks treatment.2.3.2 Emotions curative effect2.3.2.1 The time that constipation affects emotions:Compared to the baseline, the average of weekly time change during the period of 4 weeks treatment and 8 weeks treatment.2.3.2.2 The degree of influence that constipation affects emotions:Compared to the baseline, the average of weekly degree of influence during the period of 4 weeks treatment and 8 weeks treatment.2.4 Safety evaluationAdverse events during the trial and patient acceptance.Results1 Constipation treatment resultsComparison of general information and defecation before the treatment 70 subjects, fall off 1 case during the research, included in the study of 35 cases in the treatment group,34 cases in the control group. Using chi square x list of inspection, there was no significant different comparasion of the sex ratio among the two groups (P>0.05).Using independent sample t-test analysis, there was no significant different comparasion of average age, course of disease and defecation situation before the treatment between the two groups (P>0.05).2 Constipation treatment results2.1 SBMBy t test,we get that t=-5.385,p=0.000<0.05. That shows a statistically significant difference of SBM at different time points.2.2 Difficult defecation scoreThrough Non-parametric test, it shows a statistically difference of difficult defecation at differenttime points (P<0.01).And there were statistically difference in two groups (P<0.01).3 emotion treatment results3.1 The time that constipation impact emotionThrough Non-parametric test,we get that z=-2.958,p= 0.003< 0.05. It shows a statistically difference of time that constipation impact emotion at differenttime points.3.2 The degree that constipation affects emotionsBy t test,we get that t=-4.412,p=0.000< 0.05.It shows a statistically difference the degree that constipation affects emotions at differenttime points.4 Safety evaluationDuring the test, there were 8 cases with local itching, pain and skin bruises, all of their symptoms disappeared within 2-48 h. The patients of EAgroup have more discomfort feeling than sham EAgroup, but both can be accepted by patients. It proves that electroacupuncture and deeply needling method are safe.Conclusions1 It is safe and effectiveness to treat severe functional constipation by electroacupuncture and deeply needling Tianshu (ST25), Fujie (SP14) and normally needling Shangjuxu (ST37).2 Constipation can lead to emotion disorders. Both constipation and emotion disorders can be relieved when treating constipation by electroacupuncture.It has obvious correlationship between the improvement ofconstipation and emotion disorders.