中药穴位贴敷治疗痔疮术后疼痛的Meta分析

Meta-analysis of acupoint application of traditional Chinese medicine in the treatment of postoperative pain of hemorrhoids

目的系统评价中药穴位贴敷对于痔疮术后疼痛的治疗效果,并分析起效时间规律。方法检索中国知网(CNKI)、万方(WF)、维普(VIP)、中国生物医学文献数据库(CBM)、Embase、Cochrane Library及Pubmed数据库中关于中药穴位贴敷疗法治疗痔疮术后疼痛的随机对照试验(RCT),检索时限均为从数据库建立至2022年3月,对最终纳入的文献进行资料提取和质量评价,并运用Review Manager 5.4进行Meta分析。结果纳入文献共19篇,样本量为1571例。Meta分析结果显示,贴敷组的末次视觉模拟疼痛评分(VAS)显著低于对照组[SMD=-1.40,95%CI(-1.74,-1.06),P<0.00001],贴敷后6 h内贴敷组和对照组的VAS评分差异无统计学意义,贴敷后1 d、3 d、5 d和7 d贴敷组明显比对照组的VAS评分低。结论中药穴位贴敷能够有效治疗痔疮术后疼痛,疗效于贴敷1 d后显著,且至少持续至开始贴敷后7 d,但由于受到纳入文献质量、数量及研究设计的限制,尚需更多高质量、多中心的随机对照试验对本文结论加以支持。

Objective To systematically evaluate the effect of acupoint application of traditional Chinese medicine on postoperative pain of hemorrhoids and analyze the law of onset time.Methods China National Knowledge Infrastructure(CNKI),Wanfang(WF),VIP(VIP),China Biology Medicine(CBM),Embase,Cochrane Library and Pubmed databases were searched for randomized controlled trials(RCT)on acupoint application of traditional Chinese medicine in the treatment of postoperative pain after hemorrhoids.The retrieval time was from the establishment of the database to March 2022.Data extraction and quality evaluation were performed for the final included literatures,and Meta-analysis was performed by Review Manager 5.4.Results A total of 19 literatures were included,with a sample size of 1571 cases.The Results of Meta-analysis showed that the last visual analogue scale(VAS)pain score of the application group was significantly lower than that of the control group[SMD=-1.40,95%CI(-1.74,-1.06),P<0.00001],and there was no significant difference in VAS score between the application group and the control group within 6 hours after application.The VAS scores at 1 d,3 d,5 d and 7 d after application were significantly lower than those in the control group.Conclusion Acupoint application of traditional Chinese medicine can effectively treat postoperative pain of hemorrhoids,and the effect is significant after 1 day of application,and lasts until at least 7 days after the beginning of application.However,due to the limitation of the quality,quantity and study design of the included literature,more high-quality,multicenter randomized controlled trials are needed to support the Conclusion of this paper.