足三里穴位注射治疗术后胃肠功能障碍疗效与安全性的Meta分析

Meta-analysis of the Efficacy and Safety of Zusanli(ST36)Acupoint Injection for Postoperative Gastrointestinal Dysfunction

【目的】系统评价足三里穴位注射治疗术后胃肠功能障碍的疗效与安全性。【方法】计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、美国医学在线(PubMed)、荷兰医学文献数据库(Embase)、Web of Science及国际循证医学图书馆(Cochrane Library)等数据库,检索有关足三里穴位注射治疗术后胃肠功能障碍的随机对照试验(RCT)。依据Cochrane系统评价方法进行文献数据提取和质量评价,应用RevMan 5.3软件进行Meta分析。【结果】共纳入24篇文献,2081例患者被纳入最终分析。结果显示,足三里穴位注射与常规治疗比较,足三里穴位注射可显著缩短肠鸣音恢复时间[MD=-10.99,95%CI(-13.84,-8.15)]、肛门排气时间[MD=-28.72,95%CI(-35.60,-21.83)]、首次排便时间[MD=-12.34,95%CI(-16.39,-8.29)]。足三里穴位注射与肌肉注射比较,足三里穴位注射可显著缩短肠鸣音恢复时间[MD=-10.22,95%CI(-18.79,-1.65)]、肛门排气时间[MD=-17.41,95%CI(-27.41,-7.41)]、首次排便时间[MD=-16.21,95%CI(-31.91,-0.51)]。足三里穴位注射组与常规治疗组相比,足三里穴位注射可降低腹胀发生率[RR=0.33,95%CI(0.21,0.52)]、呕吐发生率[RR=0.20,95%CI(0.09,0.43)]、胃液量[MD=-535.61,95%CI(-1080.05,-8.84)]。总有效率方面,足三里穴位注射组显著高于常规治疗组[RR=1.20,95%CI(1.08,1.33)]。所有研究均未见不良反应报道。【结论】足三里穴位注射治疗术后胃肠功能障碍能够显著缩短肠鸣音恢复时间、肛门排气时间、首次排便时间,降低腹胀和呕吐发生率,有较好的疗效与安全性。

Objective To systematically evaluate the efficacy and safety of Zusanli(ST36)acupoint injection in the treatment of postoperative gastrointestinal dysfunction(POGD).Methods We searches of the China National Knowledge Internet(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),China Science and Technology Journal Database(VIP),PubMed,The Exerpta Medical Database(Embase),Web of Science and The Cochrane Library databases by computer,and the randomised controlled trials(RCTs)on the treatment of POGD with Zusanli(ST36)acupoint injections were searched.The literature data were extracted and evaluated for quality according to the Cochrane systematic evaluation method,and Meta-analysis was performed using RevMan5.3 software.Results A total of 24 publications with a total of 2081 patients were included in the final analysis.The results showed that Zusanli(ST36)acupoint injection significantly reduced the time to recovery of bowel sounds being MD=-10.99,95%CI(-13.84,-8.15),time to anal discharge being MD=-28.72,95%CI(-35.60,-21.83)and time to first bowel movement being MD=-12.34,95%CI(-16.39,-8.29).Compared with intramuscular injection,Zusanli(ST36)acupoint injection significantly reduced the time to recovery of bowel sounds being MD=-10.22,95%CI(-18.79,-1.65),time to anal discharge being MD=-17.41,95%CI(-27.41,-7.41),time to first bowel movement being MD=-16.21,95%CI(-31.91,-0.51).Compared with the conventional treatment group,Zusanli(ST36)acupoint injection reduced the incidence of abdominal distension being RR=0.33,95%CI(0.21,0.52),vomiting being RR=0.20,95%CI(0.09,0.43),and gastric fluid being MD=-535.61,95%CI(-1080.05,-8.84).In terms of total effective rate,the Zusanli acupoint injection group was significantly higher than the conventional treatment group being RR=1.20,95%CI(1.08,1.33).There were no adverse effects were reported in all studies.Conclusion Zusanli(ST36)acupoint injection for the treatment of POGD has an ideal therapeutic effect and a safety profile in significantly shortening the recovery time of bowel sounds,the time of anal discharge and the time of first bowel movement,also in reducing the incidence of abdominal distention and vomiting.