胃肠手术后早期灸法促进胃肠功能恢复效果的系统评价

Effects of Early Moxibustion Therapy on Gastrointestinal Recovery after Gastrointestinal Surgery:A Systematic Review

目的系统评价胃肠手术后早期实施灸法对促进胃肠道功能恢复的效果。方法计算机检索The Cochrane Library、Web of Science、PubMed、EMbase、Ovid、EBSCO、CBM、CNKI、VIP和WanFang Data数据库,搜集关于灸法促进胃肠手术后胃肠功能恢复的随机对照试验(RCT)和半随机对照试验(quasi-RCT),检索时限均为从建库至2015年1月。由2位评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3和Stata12.0软件进行Meta分析。结果最终纳入9个RCT,4个quasi-RCT,共1 444例患者。Meta分析结果显示,与常规治疗相比,灸法联合常规治疗可明显提高胃肠功能恢复的总有效率[OR=1.26,95%CI(1.17,1.36),P<0.000 01],缩短术后首次闻及肠鸣音的时间[MD=–11.79,95%CI(–13.79,–9.78),P<0.000 01]、首次肛门排气时间[MD=–15.13,95%CI(–17.40,–12.85),P<0.000 01]及首次排便时间[MD=–34.93,95%CI(–59.33,–10.53),P=0.005],两组差异均有统计学意义。结论灸法联合常规治疗与常规治疗相比,可更好地促进术后胃肠功能恢复。但受纳入研究数量和质量限制,上述结论尚有赖于进一步开展更多大样本、多中心、高质量的RCT加以验证。

Objective To systematically review the effect of early moxibustion therapy on the recovery of gastrointestinal functioning after gastrointestinal surgery. Methods We searched The Cochrane Library, Web of Science, PubMed, EMbase, Ovid, EBSCO, CBM, CNKI, VIP and WanFang Data from inception to Jan. 2015, to collect randomized controlled trials （RCTs） and quasi-RCTs about early moxibustion therapy on the recovery of gastrointestinal functioning. Two reviewer independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 and Stata 12.0 softwares. Results A total of nine RCTs and four quasi- RCTs involving 1 444 patients were included. The results of meta-analysis indicated that, the early moxibustion therapy group was significantly superior to the control group in total effective rate （OR=1.26, 95%CI 1.17 to 1.36, P〈0.000 01）, the time to first bowel motion （MD= -11.79, 95%CI -13.79 to -9.78, P〈0.000 01）, the time to first flatus （MD= -15.13, 95%CI -17.40 to -12.85, P〈0.000 01） and the time to first passage of feces （MD= -34.93, 95%CI -59.33 to -10.53, P=0.005）. Conclusion Current evidence shows that early moxibustion therapy after gastrointestinal surgery is beneficial for promoting the recovery of gastrointestinal functioning. In addition, due to the low methodological quality of included studies, larger sample, high-quality RCTs are needed to prove the above conclusion.