Review Article

Acupuncture and Related Therapies for Treatment of Postoperative Ileus in Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Table 1

Characteristics of included studies of acupuncture and related therapies for postoperative recovery for colorectal cancer.

Study ID No. [ref]Author, year [location]N participants (baseline); mean (SD) age at baseline in years; (M/F); N groups; Duration and frequency of treatment Conventional treatment, cancer typeAcupuncture therapyControl interventionAcupuncture points

1 [36]Chao HL et al., 2013 66; T: 61.9(13.3), C: 62.8(15.7); (31/35)2; from postoperative days 1-5, three-mins, three times per dayOpen surgery, CRCAcupressureSham acupressureST36 Zusanli 足三里, NS

2 [14]Deng G et al., 2013 90; T: 56, C: 59; (52/38)2; from postoperative days 1-3, 30 min, twice dailyOpen surgery, CRCAcupuncture + electro-acupuncture + ear acupunctureSham acupuncture + sham electro-acupuncture + sham ear acupunctureST36 Zusanli 足三里, PC6 Neiguan , LI4 Hegu 合谷, SP6 Sanyinjiao 三阴, SP9 Yinglingquan 泉, ST25 Tianshu and ear point TF4 Shenmen , bilateral

3 [15]Hong X 2017 80; T: 61.2(7.2), C: 58.8(9.4); (47/33)2; ear acupressure: press Vaccaria seeds 5 times per day for 7 days, change to other ear every 2 days; moxibustion: once a day for 7 daysDixon surgery, rectal cancerMoxibustion + ear acupressureno acupuncture therapyMoxibustion points: ST36 Zusanli 足三里 and CV12 Zhongwan 中脘; ear points: CO4 Wei 胃, TF4 Shenmen, CO6 Xiaochang, CO3 Benmen贲门, unilateral

4 [16]Li JM et al., 2016 160; T: 51.3(3.16), C: 52.17(3.34)2; press Vaccaria seeds 30-60s per point, three-five times per day, change to other ear every 3-7 daysOpen radical surgery, rectal cancerEar acupressureno acupuncture therapyEar points: CO4 Wei 胃, CO5 Shierzhichang 十二指肠, CO6 Xiaochang ,CO7 Dachang, CO13 Pi 脾, CO3 Benmen贲门, unilateral

5 [17]Lu JY & Jin HM 2011 78; T: 62.25(9.38), C: 61.21(10.16); (43/35)2; Vaccaria seeds attached immediately after surgery, point pressure for 30-60s per point every 2-3 hours (more than 5 min/cycle); until recovery Radical surgery excluding Miles surgery, CRCEar acupressureno acupuncture therapyEar points: CO13 Pi 脾, CO4 Wei 胃, CO7 Dachang, CO6 Xiaochang, AH6a Jiaogan交感, CO18 Neifenmi分泌, AT4 Pizhixia 皮质下, bilateral

6 [18]Meng ZQ et al., 2010 85; T: 54.3, C: 53.1; (47/38)2; from postoperative days 1-6, 20 min, once a day, until first bowel movement or day 6, whichever came firstIntraperitoneal surgery, epidural anaesthesia, colon cancerElectro-acupunctureno acupuncture therapyST36 Zusanli 足三里, ST37 Shangjuxu巨虚, TE6 Zhigou支沟, GB34 Yanglingquan 泉, bilateral

7 [34, 35]Ng SSM et al., 2013   †165; T: 67.4(9.7), C1: 67.4(10.7), C2:68.5(10.6); (99/66)3; T & C1: from postoperative days 1-4, 20 min, once a day, until defaecation occurred or day 4, whichever was earlierLaparoscopic surgery, CRCElectro-acupunctureC1: sham electro-acupuncture, C2: no acupuncture therapyST36 Zusanli 足三里, SP6 Sanyinjiao 三阴, LI4 Hegu 合谷, TE6 Zhigou支沟, NS

8 [19]Niu CF et al., 2008 32; T & C: 52; (21/11)2; from postoperative day 1, 15 min. twice daily Radical surgery excluding Miles surgery, CRCElectro-acupunctureno acupuncture therapyST36 Zusanli 足三里, ST37 Shangjuxu 巨虚, PC6 Neiguan, NS

9 [20]Si JG & Ding RS 2015 40; T: 45, C: 46; (23/17)2; from 24 hours after surgery, 20 min once a day, till bowel sounds and passing flatus occurredRadical surgery, CRCElectro-acupunctureno acupuncture therapyST36 Zusanli 足三里, ST37 Shangjuxu巨虚, SP6 Sanyinjiao 三阴, ST25 Tianshu, LI4 Hegu 合谷, bilateral

10 [21]Tan S & Zheng CM 2015 76; T: 63.8(11.2), C: 63.2(10.5); (43/33)2; ear acupressure: Vaccaria seeds attached after surgery, pressure for 5 min every 2-3 hours; acupuncture: after surgery, 20 min once a day; until recoveryRadical surgery, CRCAcupuncture + ear acupressureno acupuncture therapyST36 Zusanli 足三里 and ear sensitive points 敏感点, NS

11 [22]Tong WY et al., 2014 84; T: 58.6(15.1), C: 59.2(14.7); (50/34)2; from 2 hours after surgery, 30 min, once a dayOpen surgery, FTP, rectal cancerAcupunctureno acupuncture therapyST36 Zusanli 足三里, PC6 Neiguan, ST37 Shangjuxu巨虚, SP4 Gongsun公孙, NS

12 [23]Wang EM 2012 60; T: 57.4(13.6), C: 56.6(12.3); (34/26)2; Vaccaria seeds attached 4 hours after surgery, pressure for 1 min on each point, every 6 hours, until recoveryUsual surgery, colon cancerEar acupressureno acupuncture therapyEar points: TF4 Shenmen, AH6a Jiaogan 交感, AT4 Pizhixia 皮质下,CO7 Dachang, CO4 Wei 胃, Ashixue 阿 (sensitive point); unilateral, change side every 4 days

13 [24]Wang HM 2011 30; T: 60.4(11.01), C: 58(10.24); (20/10)2; from 24 hours after surgery, 30 min, once a day, for 5 daysOpen surgery, FTP, CRCAcupunctureno acupuncture therapyST36 Zusanli 足三里, PC6 Neiguan, ST37 Shangjuxu巨虚, SP4 Gongsun公孙, NS

14 [25]Xiao C 2014 90; T1: 55.87(10.49), T2: 55.33(10.83), C: 54.63(10.25); (51/39)3; from 24 hours after surgery, 20 min, once a day, for 5 daysOpen radical surgery excluding Miles surgery, CRCT1:acupuncture; T2: electro-acupunctureno acupuncture therapyST36 Zusanli 足三里, ST37 Shangjuxu巨虚, bilateral

15 [26]Xiao L et al., 2016 60; T: 67.43(16.35), C: 68.52(17.16); (33/27)2; from postoperative days 1-14, 30 min twice dailyRadical surgery, colon cancer in elderly patientsAcupuncture + electro-acupunctureno acupuncture therapyST36 Zusanli 足三里, LI4 Hegu 合谷, SP6 Sanyinjiao 三阴, LU5 Chize 尺泽 (all electro); TE6 Zhigou支沟, LU7 Lieque 列缺 (both manual); all bilateral

16 [27]Yan YB 2011 30; T: 50.73(6.076), C: 50.33(5.802); (9/21)2; from postoperative days 3-7, 30 min, once a dayLaparoscopic Miles surgery, rectal cancer Dukes A-C1, recovery of urinary functionAcupuncture + moxibustionno acupuncture therapyST36 Zusanli 足三里, LI4 Hegu 合谷, SP10 Xuehai 血海, SP9 Yinglingquan 泉, SP6 Sanyinjiao 三阴, LR3 Taichong 太冲, CV4 Guanyuan关元 (moxa), CV8 Shenque(moxa), NS

17 [28]Yang JJ et al., 2011 60; T: 60.9(6.63), C: 62(6.98); (39/21)2; from postoperative day 1, 30 min, once a day, until 3 days after defecation occurredRadical surgery, CRCElectro-acupunctureno acupuncture therapyST36 Zusanli 足三里, ST37 Shangjuxu巨虚, ST39 Xiajuxu巨虚, bilateral

18 [29]Yang JF et al., 2016 72; T: 72(5.4), C: 73.4(5.6); (44/28)2; performed three times at 24 hours, 48 hours and 72 hours after surgery, application for 6 hours each timeOpen surgery, CRC in elderly patientsPoint application with warming cataplasmPoint application with non-warming cataplasmST36 Zusanli 足三里, bilateral

19 [30]Zhang SY & Du YQ 2011 70; T: 57.1(11.7), C: 59.1(8.5); (52/18)2; from postoperative days 1-10, 45 min, once a dayRadical surgery, CRCWarm needlingno acupuncture therapyST36 Zusanli 足三里, ST37 Shangjuxu巨虚, ST39 Xiajuxu巨虚, SP6 Sanyinjiao 三阴, SP9 Yinglingquan泉, NS

20 [31]Zhang XY & Lu JB 2017 80; T: 64.8(5.6), C: 67.5(6.0); (42/38)2; from 6 hours after surgery, 1 min pressure for each point, three times per day, 1 hour after meals, until postoperative day 5 Radical surgery excluding Miles surgery, CRCAcupressureno acupuncture therapyST36 Zusanli 足三里, LI4 Hegu 合谷, ST37 Shangjuxu巨虚, NS

21 [32]Zhang ZD et al., 2014 40; T: 63(9), C: 60(10); (22/18)2; at 30 min after surgery, then postoperative days 1–4, 30 min, once a dayOpen surgery, CRCElectro-acupunctureSham electro-acupunctureST36 Zusanli 足三里, bilateral

22 [33]Zhang XY et al., 2016 80; T: 64.8(6.8), C: 67.5(4.2); (41/39)2; from 6 hours after surgery, 1 min pressure for each point, three times per day, 1 hour after meals, until postoperative day 5, change ear every 2 daysUsual surgery, CRCAcupressure + ear acupressureno acupuncture therapyAcupressure points: ST36 Zusanli 足三里, LI4 Hegu 合谷, ST37 Shangjuxu 巨虚, NS; ear points: CO4 Wei 胃, CO6 Xiaochang, CO7 Dachang, unilateral

Location in which the study was conducted: 1: Mainland China; 2: USA; 3: Taiwan; 4: Hong Kong. NS: side not specified
means mentioned acupuncture sensation (deqi) was obtained. means reported in two journal articles, reference Nos. [34, 35].