title: Transcutaneous Neuromodulation at Posterior Tibial Nerve and ST36 for Chronic Constipation.
abstract: The aims of this study were to investigate the effects and possible mechanisms of transcutaneous neuromodulation (TN) in patients with chronic constipation. Twelve patients were recruited. The treatment consisted of 2-week TN and 2-week sham-TN which was performed in a crossover design. Bowel habit diary, Patient Assessment of Constipation Symptom (PAC-SYM), Patient Assessment of Constipation Quality of Life (PAC-QOL), and anorectal motility were evaluated. Electrocardiogram was recorded for the assessment of autonomic function during acute TN therapy. It was found that (1) TN improved the frequency of spontaneous defecation. After 2-week TN therapy, 83% patients had more than 3 times bowel movements per week which was significantly different from sham-TN (P = 0.01). (2) TN improved PAC-SYM and PAC-QOL scores (P < 0.001, resp.). (3) TN significantly decreased the threshold volume to elicit RAIR (P < 0.05), ameliorated rectal sensory threshold (P = 0.04), and maximum tolerance (P = 0.04). (4) TN, but not sham-TN, increased the vagal activity (P = 0.01 versus baseline) and decreased the sympathetic activity (P = 0.01, versus baseline). It was concluded that needleless TN at posterior tibial nerve and ST36 using a watch-size stimulator is effective in chronic constipation, and the effect was possibly mediated via the autonomic mechanism.
authors.affiliation: Ningbo Pace Translational Medical Research Center, Beilun, Ningbo 210029, China ; Division of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
authors.forename: Nina
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Ningbo Pace Translational Medical Research Center, Beilun, Ningbo 210029, China ; Division of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo 210029, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.affiliation: Division of Gastroenterology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo 210029, China.
authors.forename: Yuemei
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Ningbo Maida Medical Device Inc., Ningbo 210029, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Chen
authors.affiliation: Ningbo Pace Translational Medical Research Center, Beilun, Ningbo 210029, China.
authors.forename: Jieyun
authors.initials: J
authors.lastname: Yin
authors.affiliation: Division of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Lin
authors.affiliation: Ningbo Pace Translational Medical Research Center, Beilun, Ningbo 210029, China ; Division of Gastroenterology and Hepatology, Johns Hopkins Center for Neurogastroenterology, Baltimore, MD 21224, USA.
authors.forename: Jiande D Z
authors.initials: JD
authors.lastname: Chen