耳穴贴压及持续时间对产后泌乳影响的Meta分析

Effects of Auricular Plaster Therapy and Use of Time on Postpartum Lactation:A Meta Analysis

目的系统评价耳穴贴压对产后泌乳的效果及贴压持续使用时间。方法计算机检索中国期刊全文数据库、中国生物医学文献数据库、万方数据库等数据库,检索时间1996年至2016年4月,纳入耳穴贴压方法促进产妇乳汁分泌的随机对照试验(randomized controlled trial,RCT)。文献的筛选与资料提取均由2名评价员独立进行,分歧通过协商或第三方解决。纳入文献的质量根据cochrane偏倚风险评估工具进行评价,使用RevMan5.0软件进行数据处理。结果共纳入9篇文献,共计1187例产妇。Meta分析结果显示:与产后常规护理措施相比,实施耳穴贴压的产妇在24h内泌乳始动的有效率[OR=4.53,95%CI(2.81,7.33),P<0.05]、产后泌乳量充足率[OR=2.60,95%CI(1.41,4.79),P=0.002]、72h内[OR=4.52,95%CI(1.86,10.98),P<0.001]以及产后24h内血清泌乳素含量[MD=48.18,95%CI(6.43,89.93),P=0.02]差异均有统计学意义。结论产后耳穴贴压24h能促进产妇提早泌乳,增加产后泌乳量,提高产妇体内血清垂体泌乳素分泌水平,连续使用3d泌乳效果更佳。

Objective To systematically evaluate the auricular plasterturn laetation.Methods CNKI,Wanfang, CBM, EMbase, PubMed and therapy and use of time on postpar- Cochrane Library（ends April 2016） were searched to identify the relevant randomized controlled trials（RCT） studies.According to the inclusion and exclusion criteria, two reviewers independently screened literature and extracted the data.The divergences were sorted out through discussion or third party.The quality of the included literature was,evaluated according to the Cochrane Center validation list.RevManS.3 software was used to analysis the data. Results A total of 9 studies were included with 1187 cases of maternal.The Meta analysis results showed that the statistical significances of implementation of auricular points in the maternal lactation within 24 hours of the efficiency of [OR=4.53,95% CI（2.81,7.33）,P〈0.05];postpartum lactation rate in 24 hours [OR =2.60,95 %CI （1.41,4.79 ：P = 0.002）, 72 hours[OR = 4.52,95% CI （1.86,10.98, P 〈0.001）] ; within 24 hours postpartum serum prolactin content of MD= 48.18,95% CI （6.43,89.93, P = 0.02） were found between auricular point method and the routine postpartum nursing measures.Conclusions Auricular point postpartum 24h can promote the early lactation and can increase postpartum lactation,promote the secretion of maternal serum PRL levels,and yield better effectsafter continuous use of 3 days.