穴位按摩治疗脑卒中后便秘效果的Meta分析

Effects of acupressure on post-stroke constipation:a Meta-analysis

目的:分析穴位按摩对脑卒中后便秘的疗效,以期为临床应用穴位按摩治疗脑卒中后便秘病人提供循证医学依据。方法:检索中国知网(CNKI)、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、the Cochrane Library、Web of Science、EMbase数据库中关于穴位按摩治疗脑卒中后便秘的随机对照试验(RCTs),检索时限为各数据库自建库至2021年12月1日;按照纳入、排除标准和Cochrane 5.3偏倚风险评估工具对文献进行筛选和质量评价,运用RevMan 5.4软件进行Meta分析。结果:共纳入16篇文献。Meta分析结果显示:试验组有效率[RR=1.48,95%CI(1.31,1.68),P<0.00001]、便秘症状积分[MD=-4.62,95%CI(-6.06,-3.19),P<0.00001]、便秘发生率[RR=0.44,95%CI(0.31,0.64),P<0.0001]均优于对照组,差异有统计学意义。结论:现有证据表明,穴位按摩能有效改善脑卒中后便秘,降低便秘发生率。

Objective:To analyze the efficacy of acupressure on post-stroke constipation,in order to provide evidence-based medicine for clinical application of acupressure for post-stroke constipation patients.Methods:Randomized controlled trials(RCTs)on acupressure for post-stroke constipation were searched from PubMed,the Cochrane Library,Web of Science,EMbase,CNKI,WanFang Database,VIP,and CBM.The retrieval time was from the establishment of the database to December 1,2021.Literature screening and quality evaluation were carried out according to the inclusion and exclusion criteria and the Cochrane 5.3 bias risk assessment tool,and the RevMan 5.4 software was used for Meta-analysis.Results:Finally,a total of 16 articles were included.Meta-analysis results showed that:the effective rate of traditional Chinese medicine diagnosis and treatment criteria[RR=1.48,95%CI(1.31,1.68),P<0.00001],constipation symptom score[MD=-4.62,95%CI(-6.06,-3.19),P<0.00001],incidence of constipation[RR=0.44,95%CI(0.31,0.64),P<0.0001]in the experimental group was better than those of the control group,and the difference was statistically significant.Conclusion:Current evidence shows that acupressure can effectively improve constipation after stroke and reduce the incidence of constipation.