经皮穴位电刺激与假刺激联合地塞米松或托烷司琼对剖宫产术后恶心呕吐预防效果的随机对照析因试验研究

注册号:

Registration number:

ITMCTR2025001044

最近更新日期:

Date of Last Refreshed on:

2025-05-26

注册时间:

Date of Registration:

2025-05-26

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

经皮穴位电刺激与假刺激联合地塞米松或托烷司琼对剖宫产术后恶心呕吐预防效果的随机对照析因试验研究

Public title:

Transcutaneous electrical acupoint stimulation vs. sham stimulation combined with dexamethasone vs. tropisetron for preventing postoperative nausea and vomiting after cesarean delivery: protocol for a randomized controlled factorial Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

经皮穴位电刺激与假刺激联合地塞米松或托烷司琼对剖宫产术后恶心呕吐预防效果的随机对照析因试验研究

Scientific title:

Transcutaneous electrical acupoint stimulation vs. sham stimulation combined with dexamethasone vs. tropisetron for preventing postoperative nausea and vomiting after cesarean delivery: protocol for a randomized controlled factorial Trial

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李蕊桢

研究负责人:

李蕊桢

Applicant:

Ruizhen Li

Study leader:

Ruizhen Li

申请注册联系人电话:

Applicant telephone:

156 6188 8878

研究负责人电话:

Study leader's telephone:

156 6188 8878

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

ruizhen20201220@163.com

研究负责人电子邮件:

Study leader's E-mail:

ruizhen20201220@163.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

内蒙古鄂尔多斯市东胜区伊金霍洛西街23号

研究负责人通讯地址:

内蒙古鄂尔多斯市东胜区伊金霍洛西街23号

Applicant address:

No. 23, Yijinhuoluo West Street, Dongsheng District, Ordos City, Inner Mongolia Autonomous

Study leader's address:

No. 23, Yijinhuoluo West Street, Dongsheng District, Ordos City, Inner Mongolia Autonomous

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

鄂尔多斯市中心医院

Applicant's institution:

Ordos Central Hospital

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

2025-330

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

鄂尔多斯市中心医院伦理委员会

Name of the ethic committee:

Ethics Committee of Ordos Central Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2024/4/29 0:00:00

伦理委员会联系人:

杨艺丹

Contact Name of the ethic committee:

Yidan Yang

伦理委员会联系地址:

内蒙古鄂尔多斯市东胜区伊金霍洛西街23号

Contact Address of the ethic committee:

No. 23, Yijinhuoluo West Street, Dongsheng District, Ordos City, Inner Mongolia Autonomous

伦理委员会联系人电话:

Contact phone of the ethic committee:

183 4081 0198

伦理委员会联系人邮箱:

Contact email of the ethic committee:

ordoschkjk@163.com

研究实施负责(组长)单位:

鄂尔多斯市中心医院

Primary sponsor:

Ordos Central Hospital

研究实施负责(组长)单位地址:

内蒙古鄂尔多斯市东胜区伊金霍洛西街23号

Primary sponsor's address:

No. 23 Yijinhuoluo West Street Dongsheng District Ordos City Inner Mongolia Autonomous

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

江苏省

市(区县):

Country:

China

Province:

Jiangsu Province

City:

单位(医院):

苏州市相城人民医院

具体地址:

江苏省苏州市相城区华元路1060号

Institution
hospital:

Xiangcheng People's Hospital of Suzhou City

Address:

No. 1060, Huayuan Road, Xiangcheng District, Suzhou City, Jiangsu Province

国家:

中国

省(直辖市):

内蒙古自治区

市(区县):

Country:

China

Province:

Inner Mongolia Autonomous Region

City:

单位(医院):

鄂尔多斯市中心医院

具体地址:

内蒙古鄂尔多斯市东胜区伊金霍洛西街23号

Institution
hospital:

Ordos Central Hospital

Address:

No. 23, Yijinhuoluo West Street, Dongsheng District, Ordos City, Inner Mongolia Autonomous

经费或物资来源:

江苏省中医药科技发展计划项目面上项目

Source(s) of funding:

General Project of Jiangsu Province Traditional Chinese Medicine Science and Technology Development Program

研究疾病:

术后恶心呕吐

研究疾病代码:

Target disease:

Postoperative nausea and vomiting

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

析因分组(即根据危险因素或暴露因素分组)

Factorial

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

本研究拟采用2×2析因随机对照试验设计,探讨TEAS与止吐药物在预防剖宫产PONV管理中的单独及联合应用的效果,以期优化产科麻醉中PONV的综合预防策略。

Objectives of Study:

This study is designed as a 2×2 factorial randomized controlled trial to investigate the individual and combined effects of transcutaneous electrical acupoint stimulation (TEAS) and antiemetic medications in the prevention of postoperative nausea and vomiting (PONV) following cesarean section, with the aim of optimizing comprehensive PONV prevention strategies in obstetric anesthesia.

药物成份或治疗方案详述:

本研究为一项前瞻性、双盲、2×2析因设计的随机对照临床试验,旨在评估经皮穴位电刺激(TEAS)或假刺激联合地塞米松或托烷司琼对剖宫产术后恶心呕吐(PONV)预防的有效性与安全性。预计共纳入216例择期行剖宫产的足月单胎产妇。采用区组随机法将受试者随机分为四组(每组约54例): TEAS + 地塞米松组(TD组) TEAS + 托烷司琼组(TT组) 假刺激 + 地塞米松组(SD组) 假刺激 + 托烷司琼组(ST组) 所有受试者均接受标准化椎管内麻醉及术后镇痛方案。TEAS干预选择内关穴(P6),刺激频率设为2–100 Hz,电流强度根据患者耐受程度调节(以出现“得气”感为准),每次刺激持续30分钟,分别于术前30分钟、术后24小时及48小时进行。胎儿娩出后立即给予静脉注射: • 地塞米松10 mg(用于TD组和SD组); • 托烷司琼5 mg(用于TT组和ST组)。

Description for medicine or protocol of treatment in detail:

This study is designed as a prospective double-blind randomized controlled trial with a 2×2 factorial design aiming to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) or sham stimulation in combination with either dexamethasone or tropisetron for the prevention of postoperative nausea and vomiting (PONV) following cesarean delivery. A total of 216 full-term singleton parturients scheduled for elective cesarean section will be enrolled.Participants will be randomly assigned using a block randomization method into one of four groups (approximately 54 per group): TEAS + dexamethasone (TD group) TEAS + tropisetron (TT group) Sham stimulation + dexamethasone (SD group) Sham stimulation + tropisetron (ST group) All participants will receive standardized spinal anesthesia and postoperative analgesia. TEAS will be applied bilaterally at the Neiguan (P6) acupoints with a frequency of 2–100 Hz. The stimulation intensity will be adjusted according to individual tolerance targeting the sensation of "Deqi." Each session will last 30 minutes and will be administered 30 minutes before surgery and at 24 and 48 hours postoperatively. Pharmacologic interventions will be administered intravenously immediately after fetal delivery: Dexamethasone 10 mg for participants in the TD and SD groups Tropisetron 5 mg for participants in the TT and ST groups

纳入标准:

ASA 体格状态为 I–II 级; 足月单胎妊娠; 剖宫产术; 患者及其家属签署知情同意书。

Inclusion criteria

ASA physical status I-II; Patients with full term, singleton pregnancy; Scheduled for cesarean delivery; Informed consent provided by patients and their families.

排除标准:

糖尿病; 有腕管综合征病史; 剖宫产术前 24 小时内出现恶心或呕吐; 正在接受针灸治疗; 术前 24 小时内使用止吐药或糖皮质激素; 植入心脏起搏器或除颤器者。

Exclusion criteria:

Diabetes mellitus; History of carpal tunnel syndrome; Suffering from nausea or vomiting within 24 h before cesarean delivery; Current use of acupuncture therapies; Receive antiemetic or glucocorticoid within 24 h before surgery; Pacemaker or defibrillator device implantation.

研究实施时间:

Study execute time:

From 2025-05-30

To      2026-01-30

征募观察对象时间:

Recruiting time:

From 2025-05-30

To      2026-01-30

干预措施:

Interventions:

组别:

SD组

样本量:

54

Group:

sham stimulation with dexamethasone

Sample size:

干预措施:

假刺激+胎儿娩出后静脉注射地塞米松 10 mg

干预措施代码:

Intervention:

Participants received sham stimulation and intravenous dexamethasone immediately after fetal delivery

Intervention code:

组别:

ST组

样本量:

54

Group:

sham stimulation with tropisetron

Sample size:

干预措施:

假刺激+胎儿娩出后静脉注射托烷司琼5 mg

干预措施代码:

Intervention:

Participants received sham stimulation and intravenous tropisetron immediately after fetal delivery

Intervention code:

组别:

TT组

样本量:

54

Group:

TEAS with tropisetron

Sample size:

干预措施:

TEAS+胎儿娩出后静脉注射托烷司琼5 mg

干预措施代码:

Intervention:

Participants received TEAS and intravenous tropisetron immediately after fetal delivery

Intervention code:

组别:

TD组

样本量:

54

Group:

TEAS with dexamethasone

Sample size:

干预措施:

TEAS+胎儿娩出后静脉注射地塞米松 10 mg

干预措施代码:

Intervention:

Participants received TEAS and intravenous dexamethasone immediately after fetal delivery

Intervention code:

样本总量 Total sample size : 216

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

内蒙古自治区

市(区县):

Country:

China

Province:

Inner Mongolia Autonomous Region

City:

单位(医院):

鄂尔多斯市中心医院

单位级别:

三甲

Institution/hospital:

Ordos Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏省

市(区县):

Country:

China

Province:

Jiangsu Province

City:

单位(医院):

苏州市相城人民医院

单位级别:

三级

Institution/hospital:

Xiangcheng People's Hospital of Suzhou City

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

运动时的疼痛评分

指标类型:

次要指标

Outcome:

pain scores during movement

Type:

Secondary indicator

测量时间点:

术后24,48和72小时

测量方法:

Measure time point of outcome:

24, 48, and 72 hours postoperatively

Measure method:

指标中文名:

抢救镇痛药的使用

指标类型:

次要指标

Outcome:

the use of rescue analgesics

Type:

Secondary indicator

测量时间点:

术后48小时内

测量方法:

Measure time point of outcome:

within 48 hours postoperatively

Measure method:

指标中文名:

瘙痒

指标类型:

副作用指标

Outcome:

pruritus

Type:

Adverse events

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

QoR-15 评分

指标类型:

次要指标

Outcome:

QoR-15 scores

Type:

Secondary indicator

测量时间点:

术后24小时

测量方法:

Measure time point of outcome:

24 hours after surgery

Measure method:

指标中文名:

恶心

指标类型:

次要指标

Outcome:

nausea

Type:

Secondary indicator

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

电极部位瘙痒

指标类型:

副作用指标

Outcome:

itching at the electrode site

Type:

Adverse events

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

局部皮肤灼烧或疼痛

指标类型:

副作用指标

Outcome:

localized skin burning or pain

Type:

Adverse events

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

头晕

指标类型:

副作用指标

Outcome:

dizziness

Type:

Adverse events

测量时间点:

术后48小时内

测量方法:

Measure time point of outcome:

within 48 hours postoperatively

Measure method:

指标中文名:

干呕

指标类型:

次要指标

Outcome:

retching

Type:

Secondary indicator

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

静息状态的疼痛评分

指标类型:

次要指标

Outcome:

pain scores at rest

Type:

Secondary indicator

测量时间点:

术后24,48和72小时

测量方法:

Measure time point of outcome:

24, 48, and 72 hours postoperatively

Measure method:

指标中文名:

局部皮肤过敏(如发红、肿胀或麻木)

指标类型:

副作用指标

Outcome:

local skin allergy (such as redness, swelling, or numbness)

Type:

Adverse events

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

住院时间

指标类型:

次要指标

Outcome:

hospital stay duration

Type:

Secondary indicator

测量时间点:

出院时

测量方法:

Measure time point of outcome:

at discharge

Measure method:

指标中文名:

阿片类药物使用量

指标类型:

次要指标

Outcome:

opioid consumption

Type:

Secondary indicator

测量时间点:

术后48小时

测量方法:

Measure time point of outcome:

48 hours after surgery

Measure method:

指标中文名:

术后恶心呕吐的严重程度

指标类型:

次要指标

Outcome:

the severity of PONV

Type:

Secondary indicator

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

患者满意度

指标类型:

次要指标

Outcome:

patient satisfaction

Type:

Secondary indicator

测量时间点:

术后48小时

测量方法:

Measure time point of outcome:

48 hours after surgery

Measure method:

指标中文名:

呕吐

指标类型:

次要指标

Outcome:

vomiting

Type:

Secondary indicator

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

术后48小时内PONV的发生率

指标类型:

主要指标

Outcome:

the occurrence of PONV within the first 48 hours after surgery

Type:

Primary indicator

测量时间点:

术后48小时

测量方法:

Measure time point of outcome:

the first 48 hours after surgery

Measure method:

指标中文名:

头痛

指标类型:

副作用指标

Outcome:

headache

Type:

Adverse events

测量时间点:

术后48小时内

测量方法:

Measure time point of outcome:

within 48 hours postoperatively

Measure method:

指标中文名:

抢救止吐药的使用

指标类型:

次要指标

Outcome:

the use of rescue antiemetics

Type:

Secondary indicator

测量时间点:

术后48小时内

测量方法:

Measure time point of outcome:

within 48 hours postoperatively

Measure method:

指标中文名:

药物过敏

指标类型:

副作用指标

Outcome:

drug allergies

Type:

Adverse events

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

指标中文名:

血流动力学干预情况

指标类型:

副作用指标

Outcome:

interventions for hemodynamic events

Type:

Adverse events

测量时间点:

术中和术后48小时内

测量方法:

Measure time point of outcome:

during surgery and for 48 hours postoperatively

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 18
Min age years
最大 40
Max age years

Recruiting status:

Participant age:

性别:

Gender:

女性

Female

随机方法(请说明由何人用什么方法产生随机序列):

使用中心随机化系统进行分组保密措施,我们通过在线中心随机化系统以1∶1:1:1的比例将符合条件的参与者随机分入TEAS + 地塞米松组(TD组)、TEAS + 托烷司琼组(TT组)、假刺激 + 地塞米松组(SD组)、假刺激 + 托烷司琼组(ST组)。随机化序列是基于计算机生成的随机数字。

Randomization Procedure (please state who generates the random number sequence and by what method):

A central randomization system was used for confidentiality of group assignments. Eligible participants were randomly assigned in a 1:1:1:1 ratio to one of four groups (TEAS with dexamethasone, TEAS with tropisetron, sham stimulation with dexamethasone, and sham stimulation with tropisetron) by means of an online central randomization system. The randomization sequence was based on computer-generated random numbers.

盲法:

根据随机数字信息进行盲法,试验药物根据随机编码信息以盲法方式标记,整个研究采用双盲设计。患者的临床管理与数据收集按编号顺序进行,并由未直接参与研究的医务人员负责,以保证盲法实施。为维持盲法,地塞米松与托烷司琼均通过外观一致的5 ml注射器进行分发。由于TEAS干预过程中需评估产妇是否出现“得气”感,操作者对刺激形式不实施盲法,但其不参与研究的其他环节。产妇将被统一告知:刺激可能会引起疼痛,也可能无明显感觉,但其对所接受的为真实刺激或假刺激保持盲态。除干预操作者外,所有研究人员,包括围术期评估者,均对受试者分组情况保持盲态。

Blinding:

Trial drugs were labeled in a blinded manner based on random number information. The trial had a double-blind design. Clinical management of patients and data collection were sequentially numbered and disclosed by medical staff not directly involved.To maintain blinding, dexamethasone and tropisetron will be distributed in identical 5-ml syringes. The TEAS intervention is not blinded for the interventionist, as they will need to inquire about the "de qi" sensation during the procedure. However, the interventionist will not participate in other aspects of the study. Parturients will be informed that the stimulation may cause pain, or it may not, and will remain blinded to whether they are receiving real or sham stimulation. All other study personnel, including perioperative assessors, will also remain blinded to group allocation.

是否共享原始数据:

IPD sharing:

Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

论文发表后即公开原始数据。试验的原始数据上传至中国临床试验注册中心的ResMan原始数据共享平台(IPD共享平台),http://www.medresman.org.cn.

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

The original data will be made public once the paper is published.The original data of the trial will be uploaded to the ResMan, http://www.medresman.org.cn.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

同时采用病历记录表和电子管理系统进行数据管理

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form and Electronic Data Capture are used for data management simultaneously.

数据管理委员会:

Data Managemen Committee:

Yes

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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