针灸对腹腔镜术后胃肠功能紊乱疗效的Meta分析

Meta-analysis of the Curative Effect of Acupuncture on Gastrointestinal Dysfunction after Laparoscopic Surgery

目的评价针灸治疗对腹腔镜术后胃肠功能紊乱的疗效。方法通过计算机检索中国期刊全文数据库(CNKI)、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM)、重庆维普全文数据库(VIP)、PubMed、Embase等国内外主要数据库,纳入有关针灸治疗腹腔镜术后胃肠功能紊乱的随机对照试验(randomized clinical trials,RCT),对纳入的文献进行资料提取和质量评价后采用RevMan 5.3统计软件进行Meta分析。结果最终纳入13个RCT,共985例患者。Meta分析结果显示:与对照组比较(常规处理),处理组(针灸治疗+常规处理)对腹腔镜术后胃肠功能恢复的有效率更高[RR=1.27,95%CI(1.14,1.42),P<0.0001];首次肛门排气时间更短[MD=-11.48,95%CI(-16.66,-6.31),P<0.0001];肠鸣音恢复时间更短[SMD=-2.36,95%CI(-3.02,-1.69),P<0.00001];首次肛门排便时间更短[SMD=-2.37,95%CI(-3.34,-1.40),P<0.00001]。结论针灸可以有效促进腹腔镜术后胃肠功能紊乱的恢复。但是,由于所纳入的文献证据质量等级不高,因此仍需要通过临床大样本、多中心、高质量的随机双盲试验来进一步补充验证。

Objective To evaluate the curative effect of acupuncture treatment on gastrointestinal dysfunction after laparoscopic surgery.Methods Through computer search of China Journal Full-text Database(CNKI),Wanfang Data,China Biomedical Literature Database(CBM),Chongqing VIP Full-text Database(VIP),PubMed,Embase and other major domestic and foreign databases,including related acupuncture Randomized clinical trials(RCT)for the treatment of gastrointestinal dysfunction after laparoscopic surgery.After data extraction and quality evaluation of the included literature,the RevMan 5.3 statistical software was used for Meta analysis.Results Finally,13 RCTs were included,a total of 985 patients.The results of Meta analysis showed that compared with the control group(conventional treatment),the treatment group(acupuncture treatment+conventional treatment)had a higher effective rate of recovery of gastrointestinal function after laparoscopic surgery[RR=1.27,95%CI(1.14,1.42),P<0.0001];the first anal exhaust time is shorter[MD=-11.48,95%CI(-16.66,-6.31),P<0.0001];bowel sound recovery time is shorter[SMD=-2.36,95%CI(-3.02,-1.69),P<0.00001];the first anal defecation time is shorter[SMD=-2.37,95%CI(-3.34,-1.40),P<0.00001].Conclusion Acupuncture can effectively promote the recovery of gastrointestinal dysfunction after laparoscopic surgery.However,because the quality of the included literature is not high,it still needs to be further verified by a large clinical sample,multi-center,high-quality randomized double-blind trial.