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Ear-Vagus Nerve Stimulation and Body Acupuncture for Gut Motility in Elderly ICU Patients

1. Oktober 2026 aktualisiert von: Qian Zhang, The First Affiliated Hospital with Nanjing Medical University

Auricular Vagus Nerve Stimulation Combined With Body Acupuncture for Gut-Brain Axis Modulation and Improved Gastrointestinal Motility in Elderly Critically Ill Patients

This study aims to investigate whether acupuncture, specifically a combination of body acupuncture and ear vagus nerve stimulation (taVNS), can improve gastrointestinal function in critically ill elderly patients in the Intensive Care Unit (ICU). Gastrointestinal motility problems, such as delayed stomach emptying and constipation, are common in elderly ICU patients and can interfere with feeding, increase infection risk, and worsen outcomes. This research will test if adding acupuncture to standard care helps patients tolerate tube feeding (enteral nutrition) faster, reduces the need for intravenous nutrition, and improves overall recovery. Participants will be randomly assigned to one of three groups: standard care alone, standard care plus body acupuncture, or standard care plus both body acupuncture and ear vagus nerve stimulation. The study will compare the time it takes to achieve target feeding goals, changes in gastrointestinal function scores, and other clinical outcomes. This single-center, prospective, randomized controlled trial will enroll 60 elderly patients from the Geriatric ICU of Jiangsu Province Hospital and aims to provide evidence for integrating traditional Chinese medicine into critical care practice.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

60

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

65 Jahre und älter (Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  1. Age ≥ 65 years.
  2. Critically ill patients admitted to the ICU with APACHE II score ≥ 15.
  3. NRS 2002 score ≥ 3 at ICU admission, indicating risk of malnutrition and requiring nutritional support.
  4. Presence of gastrointestinal dysfunction or at risk, with AGI grade I-II.
  5. Condition considered reversible.
  6. Written informed consent obtained from the participant or legal representative before any study procedures.

Exclusion Criteria:

  1. ICU length of stay less than 7 days.
  2. Presence of severe gastrointestinal disease with contraindications to enteral nutrition and inability to receive conventional medications via the enteral route, such as acute gastrointestinal bleeding, mechanical intestinal obstruction, post-abdominal surgery, or abdominal compartment syndrome.
  3. Skin lesions at the acupuncture sites that are not suitable for acupuncture treatment.
  4. Advanced malignancy with significantly shortened life expectancy.
  5. Participation in another clinical trial.
  6. The treating clinician determines that the intervention is not in the patient's best interest.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Unterstützende Pflege
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Aktiver Komparator: Standard Care Group

Standard Care Group

Standard ICU care including hemodynamic management, enteral nutrition support per protocol (energy target: 25 kcal/kg ideal body weight/day; protein target: 1.3 g/kg ideal body weight/day), and management of feeding complications such as diarrhea, abdominal distension, and gastric retention. Enteral nutrition is initiated within 24-48 hours of ICU admission.

Aktiver Komparator: Body Acupuncture Group

Participants receive standard ICU care plus body acupuncture therapy. Acupuncture is performed daily by a licensed acupuncturist with 10 years of experience. Needles are inserted at acupoints including CV12, CV10, ST36, PC6, and others, retained for 30 minutes per session. The intervention continues from ICU admission until ICU discharge, death, or discontinuation of nutritional support.

Standard ICU care including hemodynamic management, enteral nutrition support per protocol (energy target: 25 kcal/kg ideal body weight/day; protein target: 1.3 g/kg ideal body weight/day), and management of feeding complications such as diarrhea, abdominal distension, and gastric retention. Enteral nutrition is initiated within 24-48 hours of ICU admission.

Acupuncture at body acupoints including CV13 (Shangwan), CV12 (Zhongwan), CV10 (Xiawan), ST21 (Liangmen), ST25 (Tianshu), SP15 (Daheng), CV4 (Guanyuan), CV6 (Qihai), CV7 (Yinjiao), LI4 (Hegu), TE6 (Zhigou), ST36 (Zusanli), ST37 (Shangjuxu), ST41 (Jiexi), and LR3 (Taichong). Sterile disposable needles (0.25mm × 40mm) are inserted 1-1.5 cun to achieve deqi sensation, retained for 30 minutes per session, once daily.

Experimental: Combined Auricular VNS and Body Acupuncture Group

Participants receive standard ICU care, body acupuncture (as described in Arm 2), and additional transcutaneous auricular vagus nerve stimulation (taVNS). A medium-frequency electrical stimulator is applied to the cymba concha region of the ear (25 Hz, 0-2 mA, 30 minutes per session, once daily). The intervention continues from ICU admission until ICU discharge, death, or discontinuation of nutritional support.

Standard ICU care including hemodynamic management, enteral nutrition support per protocol (energy target: 25 kcal/kg ideal body weight/day; protein target: 1.3 g/kg ideal body weight/day), and management of feeding complications such as diarrhea, abdominal distension, and gastric retention. Enteral nutrition is initiated within 24-48 hours of ICU admission.

Acupuncture at body acupoints including CV13 (Shangwan), CV12 (Zhongwan), CV10 (Xiawan), ST21 (Liangmen), ST25 (Tianshu), SP15 (Daheng), CV4 (Guanyuan), CV6 (Qihai), CV7 (Yinjiao), LI4 (Hegu), TE6 (Zhigou), ST36 (Zusanli), ST37 (Shangjuxu), ST41 (Jiexi), and LR3 (Taichong). Sterile disposable needles (0.25mm × 40mm) are inserted 1-1.5 cun to achieve deqi sensation, retained for 30 minutes per session, once daily.

Medium-frequency electrical stimulator (SNM-FDCM01, Ningbo Maida Medical Instruments Co., Ltd.) applied to the cymba concha region of the ear. Parameters: active period 2 seconds, rest period 3 seconds; pulse width 0.5 ms; frequency 25 Hz; intensity 0-2 mA (maximum tolerable by patient); 30 minutes per session, once daily.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Zeitfenster
Time to Achieve Enteral Nutrition Target
Zeitfenster: From ICU admission up to 28 days
From ICU admission up to 28 days

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in Acute Gastrointestinal Injury (AGI) Grade
Zeitfenster: Baseline Day3 Day 7
Baseline Day3 Day 7
Change in Feeding Intolerance Score (FIS)
Zeitfenster: Baseline Day3 Day 7

Minimum Value: 0 (The lowest score, where all evaluation items are scored as 0).

Maximum Value: 15. The score is calculated by summing three items (abdominal distension and/or pain + nausea and/or vomiting + diarrhea). Since each item has a maximum score of 5, the theoretical maximum total score is 5 + 5 + 5 = 15.

Interpretation (Higher vs. Worse): Higher scores indicate a worse outcome. A higher score represents more severe feeding intolerance (e.g., severe abdominal distension, frequent vomiting, massive diarrhea), requiring stricter clinical management. According to the notes in the image:

0-2 points: Continue enteral nutrition, increase or maintain the original rate, and provide symptomatic treatment.

3-4 points: Continue enteral nutrition, slow down the rate, and reassess after 2 hours.

≥5 points: Suspend enteral nutrition and take corresponding management measures.

Baseline Day3 Day 7
Change in Gastrointestinal Dysfunction Score (GIDS)
Zeitfenster: Baseline Day3 Day 7

Minimum Value: 0 (0 - No risk: No symptoms, or any of the listed conditions present at the time of oral intake).

Maximum Value: 4 (4 - Life-threatening: One of the listed conditions present).

Interpretation (Higher vs. Worse): Higher scores indicate a worse outcome. Higher scores represent more severe gastrointestinal dysfunction and a higher risk of mortality. The specific grades are as follows:

0 (No risk): No symptoms, or any of the following conditions present at the time of oral intake (e.g., absent bowel sounds, vomiting, gastric residual volume >200ml, etc.).

  1. (Increased risk): Two of the following symptoms are present (e.g., no oral intake, absent bowel sounds, vomiting, gastric residual volume >200ml, etc.).
  2. (Gastrointestinal dysfunction): Three or more symptoms scored as 1, OR two of the following symptoms (severe diarrhea, gastrointestinal bleeding requiring transfusion, intra-abdominal pressure >20 mmHg).
  3. (Gastrointestinal failure): Three or more of the followin
Baseline Day3 Day 7
Change in Intra-Abdominal Pressure (IAP)
Zeitfenster: Baseline Day3 Day 7
Baseline Day3 Day 7
Change in Plasma Levels of Intestinal Injury Biomarkers (I-FABP)
Zeitfenster: Baseline Day 7

ng/mL

Baseline Day 7
Change in Plasma Levels of Intestinal Injury Biomarkers (DAO)
Zeitfenster: Baseline and Day 7

ng/mL

Baseline and Day 7
Proportion of Participants Requiring Supplemental Parenteral Nutrition (SPN)
Zeitfenster: Day 7
Day 7
Incidence of Secondary Intestinal Infections
Zeitfenster: Up to 28 days from ICU admission
Up to 28 days from ICU admission
Duration of Mechanical Ventilation
Zeitfenster: Up to 28 days from ICU admission
Up to 28 days from ICU admission
Length of ICU Stay
Zeitfenster: Up to 28 days from ICU admission
Up to 28 days from ICU admission
28-Day Mortality
Zeitfenster: Day 28
Day 28
Change in Plasma Levels of Citrulline
Zeitfenster: Baseline and Day 7

μmol/L

Baseline and Day 7

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. September 2026

Primärer Abschluss (Geschätzt)

1. Dezember 2027

Studienabschluss (Geschätzt)

1. Dezember 2028

Studienanmeldedaten

Zuerst eingereicht

20. September 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

1. Oktober 2026

Zuerst gepostet (Tatsächlich)

6. Oktober 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

6. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

1. Oktober 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 2026-SR-295

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

The de-identified individual participant data (IPD) that underlie the results reported in this article, including data dictionaries, will be made available to researchers who provide a methodologically sound proposal. Data will be available beginning 9 months and ending 36 months following article publication. Proposals should be directed to dongjiaxin1861@163.com. To gain access, data requestors will need to sign a data access agreement.

IPD-Sharing-Zeitrahmen

Data will be available beginning 9 months and ending 36 months following article publication.

IPD-Sharing-Zugriffskriterien

De-identified individual participant data and supporting information will be made available to researchers whose proposed use of the data has been approved by an independent review committee. Requests must be directed to the corresponding author (dongjiaxin1861@163.com) and requestors must sign a data access agreement.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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