Acupuncture in Critically Ill Patients Improves
Delayed Gastric Emptying
Pfab F, et al. Department of Anesthesiology, University
Hospital Regensburg, Regensburg, Germany
Background: Malnutrition remains a severe problem in the
recovery of critically ill patients and leads to increased in-hospital morbidity and in-hospital stay.
Even though early enteral nutrition has been shown to improve overall patient outcomes in the intensive
care unit (ICU), tubefeed administration is often complicated by delayed gastric emptying and
gastroesophageal reflux. Acupuncture has been successfully used in the treatment and prevention of
perioperative nausea and vomiting. In this study we evaluated whether acupuncture can improve gastric
emptying in comparison with standard promotility drugs in critically ill patients receiving enteral
feeding. Methods: Thirty mechanically ventilated neurosurgical ICU patients with delayed gastric emptying,
defined as a gastric residual volume (GRV) >500 mL for ≥2 days, were prospectively and randomly assigned
to either the acupoint stimulation group (ASG; bilateral transcutaneous electrical acupoint stimulation at
Neiguan, PC-6) or the conventional promotility drug treatment group (DTG) over a period of 6 days
(metoclopramide, cisapride, erythromycin). Patients in the ASG group did not receive any conventional
promotility drugs. Successful treatment (feeding tolerance) was defined as GRV <200 mL per 24 hours.
Results: Demographic and hemodynamic data were similar in both groups. After 5 days of treatment, 80%
of patients in the ASG group successfully developed feeding tolerance versus 60% in the DTG group. On
treatment day 1, GRV decreased from 970 ± 87 mL to 346 ± 71 mL with acupoint stimulation (P = 0.003),
whereas patients in the DTG group showed a significant increase in GRV from 903 ± 60 mL to 1040 ± 211 mL
(P = 0.015). In addition, GRV decreased and feeding balance (defined as enteral feeding volume minus GRV)
increased in more patients in the ASG group (14 of 15) than in the DTG group (7 of 15; P = 0.014).
On treatment day 1, the mean feeding balance was significantly higher in the ASG group (121 ± 128 mL)
than in the DTG group (-727 ± 259 mL) (P = 0.005). Overall, the feeding balance improved significantly
on all days of treatment in comparison with the DTG group. Patients in the DTG group did not show an
increase in feeding balance until day 6. Conclusions: We introduce a new protocol for acupuncture
administration in the critical care setting. We demonstrated that this protocol was more effective
than standard promotility medication in the treatment of delayed gastric emptying in critically ill
patients. Acupoint stimulation at Neiguan (PC-6) may be a convenient and inexpensive option (with few
side effects) for the prevention and treatment of malnutrition in critically ill patients.
Anesth Analg. 2010 Nov 16.
Acupuncture for Treating Dry Eye
Shin MS, et al. Acupuncture, Moxibustion and Meridian Research Center, Korea Institute of
Oriental Medicine, Daejeon, Korea Department of Acupuncture & Moxibustion, College of Korean Medicine,
Kyung Hee University, Seoul, Korea Department of Internal Medicine, School of Korean Medicine, Pusan
National University, Yangsan, Korea.
Purpose: To evaluate the efficacy and safety of acupuncture for ocular symptoms, tear film stability and
tear secretion in dry eye patients. Methods: This is a randomized, patient-assessor blinded, sham
acupuncture controlled trial. Forty-two participants with defined moderate to severe dry eye underwent
acupuncture treatment three times a week for 3 weeks. Seventeen standard points (GV23; bilateral BL2,
GB14, TE23, Ex1, ST1 and GB20; and unilateral SP3, LU9, LU10 and HT8 on the left for men and right for
women) with 'de qi' manipulation for the verum acupuncture group and seventeen sham points of shallow
penetration without other manipulation for the sham group were applied during the acupuncture treatment.
Differences were measured using the ocular surface disease index (OSDI), the visual analogue scale (VAS)
of ocular discomfort, the tear film break-up time (BUT) and the Schimer I test with anaesthesia. In
addition, adverse events were recorded. Results: There were no statistically significant differences
between results on the OSDI, VAS, BUT or Schimer I tests from baseline between the verum and sham
acupuncture groups. However, results from the within-group analysis showed that the OSDI and VAS in both
groups and the BUT in the verum acupuncture group were significantly improved after 3 weeks of
treatment. No adverse events were reported during this trial. Conclusion: Both types of acupuncture
improved signs and symptoms in dry-eye patients after a 4-week treatment. However, verum acupuncture
did not result in better outcomes than sham acupuncture.
Acta Ophthalmol.2010 Nov 10.
Spatholobus Suberectus (Ji Xue Teng) Inhibits Cancer Cell Growth
Wang ZY, et al School of Chinese Medicine, The University of Hong Kong,
Pokfulam, Hong Kong, China.
AIM OF THE STUDY: Although herbs have long been alternatively applied for cancer
treatment in China, its treatment effects and their potential mechanisms have not been sufficiently
investigated. The chinese herb Spatholobus suberectus (SS) is commonly prescribed to cancer patients. In
this study, the anti-cancer effect of SS and its molecular mechanisms have been investigated. MATERIALS
AND METHODS: The effect of SS on cell proliferation was studied by cell growth assay and flow cytometry
on breast cancer cell lines MCF-7 and colon cancer cell line HT-29. The role of SS in apoptosis was
studied by flow cytometry, DNA fragmentation assay and mitochondrial membrane potential assay. Expression
of proteins associated with cell cycle and apoptosis was determined by Western blot analysis. The in
vivo effect of SS was tested in nude mouse cancer xenografts. RESULTS: Cell growth assay showed that SS
effectively inhibits tumor cell growth in a dose-dependent manner. Flow cytometry analysis showed that
SS could arrest the cell cycle at G2/M checkpoint, which is associated with DNA damage and activation of
phosphor-Chk1/Chk2. The pro-apoptotic effect of SS was demonstrated by Annexin V-PI staining and
mitochondrial membrane potential assay. In vivo experiments show that the efficiency of SS alone group
was superior to docetaxel or to docetaxel and SS combined. No obvious body weight loss or blood
toxicity was observed in SS tested animals. CONCLUSIONS: Our data demonstrates that SS is a potential
herb for cancer treatment by inhibiting tumor growth via induction of apoptosis and arrest of the
cell cycle at G2/M phase.
J Ethnopharmacol. 2010 Nov 9.