中医外治法促进妇科腹腔镜手术后胃肠功能恢复的Meta分析

Effect of external therapy of traditional Chinese Medicine on the recovery of gastrointestinal function after gynecologic laparoscopic surgery: a meta-analysis

目的系统评价中医外治法在妇科腹腔镜手术后胃肠功能恢复中应用的效果。方法计算机检索中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、中国科技期刊数据库(VIP)、万方科技期刊全文数据库(WANFANG Data)等中文数据库以及Pub Med、Cochrane协作网、JBI循证护理中心图书馆等外文数据库。搜集中医外治法促进妇科腹腔镜手术后胃肠功能恢复效果的临床随机对照试验(RCTs)和临床对照试验(CCTs)文献;经筛选文献、偏倚风险评估、数据提取后,采用Revman5. 3软件进行meta分析。结果最终纳入13篇RCT,共1 349例患者。Meta分析结果显示,中医外治法在缩短肠鸣音恢复时间[MD=-8. 90,95%CI(-13. 90,-3. 91),P <0. 01]、肛门首次排气时间[M D=-10. 05,95%CI(-12. 37,-7. 74),P<0. 01]、首次排便时间[M D=-14. 14,95%CI(-20. 75,-7. 54),P <0. 01]方面与常规组相比,差异均有统计学意义。结论中医外治法可缩短妇科腹腔镜手术后肠鸣音恢复时间、肛门首次排气时间和首次排便时间;由于文献质量和数量限制,但仍需要大样本、高质量的相关研究进行验证。

Objective To systematically review the effect of traditional Chinese medicine （TCM） external treatment on the recovery of gastrointestinal function after gynecologic laparo- scopic surgery. Methods The randomized controlled trials （RCTs）and clinical controlled trials （CCTs） on TCM external treatment after gynecologic laparoscopic surgery were collected using the databases of China Biomedical Literature Database （CBM）, Chinese Academic Journal Full- text Database （CNKI）, Chinese Science and Technology Periodical Database （VIP） , WANGA- NG Data, PubMed, Cochrane Library, JBI Evidence-based Nursing Center Library. After selec- tion and critical appraisal of the retrieved studied, Meta-analysis was conducted by RevMan 5.3 software. Results Twelve RCTs with 1376 patients were included. Meta-analysis revealed that TCM external treatment after gynecologic laparoscopic surgery could significantly shorten the time to bowel sound recovery time（MD= -8.90, 95%CII -13-90, -3.911, P〈0-01）, time to first o first flatus（MD = - 10.05,95% CII - 12.37, -7. 741, P 〈0.01 ） time to first passage of feces（MD = -14.14, 95% CII -20.75, -7. 541, P 〈0.01）. Conclusion Limited by the number and quality of studies included, TCM external treatment can shorten the recovery time of bowel sounds, the first o first flatus and the first passage of feces, but still need large samples andhigh-quality relevant research to verify.