针刺辅助治疗改善急性胰腺炎患者胃肠功能的Meta分析

Meta-analysis of Acupuncture as Adjuvant Therapy in Improving Gastrointestinal Function of Acute Pancreatitis Patients

【目的】评价针刺疗法辅助治疗急性胰腺炎的疗效。【方法】检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方、Pub Med、EMBase、Cochrane Library等数据库中有关以西医常规治疗作为对照组、以西医常规治疗结合针刺疗法作为观察组的急性胰腺炎疗效观察的随机对照临床试验(RCT),对符合纳入和排除标准的入选文献的质量进行系统评价;提取相关数据,采用Rev Man5.3软件进行Meta分析。【结果】共有7项RCT合计371例AP患者纳入本研究。针刺疗法辅助治疗组的腹痛缓解时间(WMD=-1.44;95%CI:-2.38,-0.50)、腹胀缓解时间(WMD=-2.50;95%CI:-4.07,-0.73)、肛门排气恢复时间(WMD=-1.79;95%CI:-3.73,-0.14)、排便时间(WMD=-1.95;95%CI:-3.51,-0.39)、肠鸣音恢复时间(WMD=-1.39;95%CI:-2.44,-0.34)、血淀粉酶恢复正常时间(WMD=-2.09;95%CI:-3.22,-0.96)、住院时间(WMD=-3.70;95%CI:-6.04,-1.36)均明显低于对照组,除肛门排气恢复时间外,其余各指标的差异均有统计学意义(P<0.05)。【结论】针刺辅助治疗急性胰腺炎能显著改善患者的胃肠功能,缩短血淀粉酶恢复时间及住院时间。但由于纳入的RCT方法学质量较低,建议开展更为严格的RCT以提供充分证据支持针刺辅助治疗AP的疗效。

Objective To evaluate the clinical effect of acupuncture as an adjuvant therapy for acute pancreatitis （AP）. Methods We retrievedthedatabasesofCNKI, VIP, Wanfang, PubMed, EMBase, and Cochrane LibralT, selected the relevant randomized clinical trials（RCTs） of AP treated with routine western medicine as control group and treated with routine western medicine combined with acupuncture therapy as trial group. And then, the quality of the qualified RCTs was evaluated, and the end-point outcomes of the RCTs were analyzed by Meta-analysis. Results A total of 7 RCTs involving 371 AP patients were included into the analysis. The time for abdominal pain relief（WMD = -1.44; 95%CI ： -2.38, -0.50） , time for abdominal distension relief （WMD = -2.50; 5%CI ： -4.07, -0.73）, time for the restart of anal exhaust（WMD = - 1.79 ; 95%CI ： -3.73, -0.14） , time for defecation （WMD =-1.95; 95%CI：-3.51, -0.39）, time for the restart of bowel sound（WMD =-1.39; 95%CI： -2.44, -0.34） , time for blood amylase becoming normal（WMD =-2.09; 95%CI： -3.22, -0.96）, and hospitalization time（WMD = -3.70; 95%CI： -6.04, -1.36） in the trial group were less than those in the control group, and the differences of the above indexes except for the time for the restart of anal exhaust were significant （P 〈 0.05）. Conclusion Acupuncture as an adjuvant therapy is effective for improving the gastrointestinal function of AP patients, and shortening time for blood amylase becoming normal and hospitalization time. However, due to the low methodological quality, more well-designed randomized controlled trials are needed to confirm the therapeutic effect of acupuncture therapy for AP.