Acupuncture for acute gastrointestinal injury:A systematic review and meta-analysis

Objective:To systematically review the clinical therapeutic effect of acupuncture on acute gastrointestinal injury(AGI)in critically ill patients.Methods:The randomized control trials of acupuncture for AGI in critically ill patients were retrieved from the databases,from inception to the cutoff date in August,2021,including China National Knowledge Infrastructure(CNKI),Wanfang,VIP,China Biology Medicine disc(CBM),PubMed,Science Direct and Cochrane Library.Simultaneously,the accomplished and published RCTs were further searched from American clinical trial registry platform(https://clinicaltrials.gov)and Chinese clinical trial registry platform(www.chictr.org.cn).Two researchers extracted the data and performed the quality evaluation of the eligible articles independently.The meta-analysis was undertaken,by using RevMan 5.4.Results:Totally,15 papers were included,involving 1316 patients.The results of meta-analysis showed that after treated with acupuncture,the differences were statistical significance as compared with the routine treatment group in the score of the second edition of Acute Physiology and Chronic Health Evaluation(APACHEII)(MD=-1.98,95%CI[-3.23,-0.73],P=0.002),gastrointestinal dysfunction score(MD=-0.33,95%CI[-0.41,-0.24],P<0.00001),the intra-abdominal pressure(mmHg)(MD=-2.74,95%CI[-3.81,-1.67],P<0.00001),intensive care unit(ICU)length of stay(MD=-3.15,95%CI[-5.99,-0.30],P<0.00001)and fatality rate in 28-day(RR=0.57,95%CI[0.39,0.85],P=0.006)in critically ill patients with AGI,respectively.Conclusion:The limited available evidence suggests that acupuncture relieves clinical symptoms and poor prognosis in the critically ill patients with AGI,thus,it is one of the potential therapies to AGI.Hence,acupuncture should be recommended into the regimen of AGI in critically ill patients and more highquality and multi-central trials can be undertaken in the further.