Ultrasound delivery of Chinese rhubarb promotes early recovery of gastrointestinal function after gastrectomy: a prospective randomized controlled study

Abstract Objective: Chinese rhubarb is a promising Chinese medicine for the promotion of gastrointestinal function. This study was conducted to investigate the safety and efficacy of Chinese rhubarb administered via ultrasound delivery in promoting the early recovery of gastrointestinal function after gastrectomy. Methods: In this prospective randomized controlled study, 100 patients who were scheduled to undergo total or subtotal gastrectomy in Changzhi People's Hospital or Subei People's Hospital from August 2017 to January 2018 were recruited. These patients were randomly assigned into two equal groups before surgery: 50 in the experimental (Chinese rhubarb) group, and 50 in the control (routine nursing) group. After surgery, time to flatus, bowel movement, clear liquid diet, and removal of nasogastric tube were recorded and analyzed. In addition, postoperative pain, postoperative bowel movement-related complications, and postoperative hospital stay duration were also recorded and analyzed. The study was approved by The protocol was approved by the Institutional Review Board of Changzhi People's Hospital and Subei People's Hospital on July 1, 2017 and registered with the Chinese Clinical Trial Registry on December 17, 2018 (registration number: ChiCTR1800020143). Results: Time to flatus (control group 85.68 ± 22.00 hours vs experimental group 73.06 ± 23.42 hours; P = 0.007), bowel movement (5.52 ± 1.56 vs 4.40 ± 1.21 days; P < 0.001), clear liquid diet (6.72 ± 1.16 vs 6.22 ± 1.28 days; P = 0.044), and removal of nasogastric tube (6.30 ± 1.52 vs 5.65 ± 1.58 days; P = 0.044) were significantly shorter in the experimental group compared with the control group, as was the postoperative hospital stay duration (14.30 ± 3.46 vs 12.86 ± 1.36 days; P = 0.006). In addition, better pain relief (P = 0.003) and a lower incidence of postoperative bowel movement-related complications (6 vs 21; P = 0.001) were noted in the experimental group. Conclusion: Ultrasound delivery of Chinese rhubarb is useful to promote the early recovery of gastrointestinal function after gastrectomy.