Objective To observe the effects of thumbtackneedle embedding therapy of auricular acupuncture on gastrointestinal function and intestinal microflora in the patients with gastric cancer after operation,and to explore ...Objective To observe the effects of thumbtackneedle embedding therapy of auricular acupuncture on gastrointestinal function and intestinal microflora in the patients with gastric cancer after operation,and to explore its mechanism.Methods A total of 80 patients with gastric cancer after radical operation were randomly divided into an observation group(40 cases,3 cases discontinued)and a control group(40 cases,3 cases discontinued).The patients of both groups received the perioperative care for accelerating recovery.Additionally,in the observation group,the thumbtack-needle embedding therapy of auricular acupuncture was delivered at the auricular points of unilateral side,including Wei(CO4),Pi(COis),Dachang(CO,),Xiaochang(CO。),Yuanzhong(AT2,3,4i),Erzhong(HX,),Sanjiao(COiz)and Jiaowozhong(TF,),and the needles were embedded and retained for 72 h.The postoperative recovery time of gastrointestinal function(the postoperative bowel sound recovery time,the first exhaust time,the first defecation time),the postoperative hospital stay and pain visual analogue scale(VAS)score were observed in the two groups.Before operation and on day 5 after operation,the serum gastrin level was detected in the two groups.The third-generation 16S rRNA sequencing technology was used to detect the composition and relative abundance of intestinal flora in the two groups before and after operation.Results Compared with the control group,the postoperative bowel sound recovery time,the first exhaust time and the first defecation time were shortened in the observation group(P<0.05).In the observation group,the VAS scores at 24 h,48 h,and 72 h after surgery were lower than those of the control group,respectively(P<0.05).There was no significant differences in postoperative hospital stay and serum gastrin level between the two groups(P>0.05).The alpha diversity analysis showed that the differences in Shannon index,Simpson index,Pielou_J index and Pd_fath index were not significant statisticallyyafter intervention between the two groups(P>0.05).After intervention,the community structure of the fecal sample was similar at each taxonomic level between the two groups,and although the proportion between species was various,the difference was not significant(P>0.05).After intervention,there were 55 species with the differences between the two groups,17 species of them presented significant difference in relative abundance in the observation group and 38 species in the control group.Regarding the level of genus,the levels of Klebsiell and Enterobacter increased(P<0.05)and the level of Streptococcus decreased(P<0.05)in the observation group.The main microbial groups that played an important role were Coprobacillaceae,Sutterellaceae and Yersiniaceae in the observation group.KEGG functionprediction indicated that the function of intestinal microfloraa was mainly associated with the cofactor and vitamin metabolism,carbohydrate metabolism,and amino acid metabolism.Conclusion The thumbtackneedle embedding therapy of auricular acupuncture improves the postoperative gastrointestinal function of the patients with gastric cancer probably through regulating the structure and relative abundance of intestinal microflora and affecting the energy metabolism.展开更多
文摘Objective To observe the effects of thumbtackneedle embedding therapy of auricular acupuncture on gastrointestinal function and intestinal microflora in the patients with gastric cancer after operation,and to explore its mechanism.Methods A total of 80 patients with gastric cancer after radical operation were randomly divided into an observation group(40 cases,3 cases discontinued)and a control group(40 cases,3 cases discontinued).The patients of both groups received the perioperative care for accelerating recovery.Additionally,in the observation group,the thumbtack-needle embedding therapy of auricular acupuncture was delivered at the auricular points of unilateral side,including Wei(CO4),Pi(COis),Dachang(CO,),Xiaochang(CO。),Yuanzhong(AT2,3,4i),Erzhong(HX,),Sanjiao(COiz)and Jiaowozhong(TF,),and the needles were embedded and retained for 72 h.The postoperative recovery time of gastrointestinal function(the postoperative bowel sound recovery time,the first exhaust time,the first defecation time),the postoperative hospital stay and pain visual analogue scale(VAS)score were observed in the two groups.Before operation and on day 5 after operation,the serum gastrin level was detected in the two groups.The third-generation 16S rRNA sequencing technology was used to detect the composition and relative abundance of intestinal flora in the two groups before and after operation.Results Compared with the control group,the postoperative bowel sound recovery time,the first exhaust time and the first defecation time were shortened in the observation group(P<0.05).In the observation group,the VAS scores at 24 h,48 h,and 72 h after surgery were lower than those of the control group,respectively(P<0.05).There was no significant differences in postoperative hospital stay and serum gastrin level between the two groups(P>0.05).The alpha diversity analysis showed that the differences in Shannon index,Simpson index,Pielou_J index and Pd_fath index were not significant statisticallyyafter intervention between the two groups(P>0.05).After intervention,the community structure of the fecal sample was similar at each taxonomic level between the two groups,and although the proportion between species was various,the difference was not significant(P>0.05).After intervention,there were 55 species with the differences between the two groups,17 species of them presented significant difference in relative abundance in the observation group and 38 species in the control group.Regarding the level of genus,the levels of Klebsiell and Enterobacter increased(P<0.05)and the level of Streptococcus decreased(P<0.05)in the observation group.The main microbial groups that played an important role were Coprobacillaceae,Sutterellaceae and Yersiniaceae in the observation group.KEGG functionprediction indicated that the function of intestinal microfloraa was mainly associated with the cofactor and vitamin metabolism,carbohydrate metabolism,and amino acid metabolism.Conclusion The thumbtackneedle embedding therapy of auricular acupuncture improves the postoperative gastrointestinal function of the patients with gastric cancer probably through regulating the structure and relative abundance of intestinal microflora and affecting the energy metabolism.
