耳穴贴压对髋膝关节置换术后患者疼痛影响的系统评价

The effect of auricular acupressure/sticking therapy on pain relief after total hip or knee replacement:a systematic review

目的评价髋膝关节置换术后行耳穴贴压的镇痛效果,为中医临床护理提供参考。方法检索国内外相关数据库自建库至2018年2月发表的关于耳穴贴压缓解髋膝关节置换术后疼痛文献。依据Cochrane手册进行质量评价及提取文献,使用Review Manager5.3.3软件进行统计学分析。结果共纳入14篇RCT,共计974例患者(耳穴贴压组490例,对照组484例)。膝关节置换术后6、12及24hVAS评分耳穴贴压组显著低于对照组,髋关节置换术后24、48及72hVAS评分耳穴贴压组显著低于对照组(P<0.05,P<0.01);术后48h内镇痛药物使用量耳穴贴压组显著少于对照组(均P<0.01)。结论在常规护理的基础上增加耳穴贴压可显著减轻髋膝关节置换术后疼痛,减少镇痛药物用量。

Objective To assess the effect of auricular acupressure/sticking therapy on pain relief after total hip or knee replacement.Methods Relevant,randomized clinical trials（RCTs）reporting the efficacy of auricular acupressure/sticking therapy on pain relief after total hip or knee replacement were identified by searching medical related databases from inception to February 2018.Obtained studies were assessed for methodological quality using the Cochrane Handbook and then meta-analysis was performed using the Review Manager 5.3.3.Results Fourteen RCTs met the inclusion criteria,involving a total of 974 patients（490 in auricular group and 484 in control group）.The Visual Analog Scale（VAS）pain scores at 6,12 and 24 hafter knee replacement were significantly lower in the auricular group than the controls,and the VAS scores at 24,48 and 72 hafter hip replacement were also lower in the auricular group than the controls（P〈0.05,P〈0.01）.The use of analgesics within 48 haffter the surgery in the auricular group was less than that of the control group（P〈0.01）.Conclusion Auricular acupressure/sticking therapy on the basis of conventional care can relieve pain and reduce the usage of analgesics after total hip or knee replacement.