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[针灸治疗胃癌术后胃肠功能障碍疗效的Meta分析]

[Meta-analysis of acupuncture and moxibustion for the therapeutic effect on postoperative gastrointestinal dysfunction of gastric cancer].

作者信息

Li Huai-Yu, Chen Yun, Hu Zi-Yi, Chen Peng, Li Ren-Liang, Jiang Jia-Wang, Ye Jing

机构信息

Graduate School, Jiangxi University of CM, Nanchang 330004, China.

Digestion Department, First Affiliated Hospital of Gannan Medical University.

出版信息

Zhongguo Zhen Jiu. 2022 May 12;42(5):595-602. doi: 10.13703/j.0255-2930.20210214-0003.

Abstract

OBJECTIVE

To systematically review the therapeutic effect of acupuncture and moxibustion on postoperative gastrointestinal dysfunction (GID) of gastric cancer with meta-analysis.

METHODS

The articles of randomized controlled trials (RCTs) of acupuncture and moxibustion treatment for postoperative GID of gastric cancer were retrieved from the following databases from the time of database establishment to December 31, 2020, including PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database and China Biomedical Literature Database (SinoMed). RevMan5.3 software was used for meta-analysis. Using Stata16.0 software, sensitivity analysis and publication bias test were performed.

RESULTS

A total of 16 RCTs were included finally, including 1 360 patients, of which, there were 681 cases in the intervention group and 679 cases in the control group. Meta-analysis results showed that acupuncture and moxibustion shortened the time of first flatus (<0.000 01, =-14.52, 95% = [-17.31, -11.74]), the time of first bowel sound (<0.000 01, =-10.50, 95% =[-13.99, -7.01]) and the time of first defecation (<0.000 1, =-13.79, 95% =[-20.09, -7.50]). Meanwhile, acupuncture and moxibustion shortened the time of the first food intake (<0.000 1, =-3.23, 95% = [-3.45, -3.00]) and the hospital stay (<0.000 01, =-1.94, 95% =[-2.20, -1.69]) after gastric cancer operation, and reduced the incidences of postoperative adverse reactions, i.e. nausea and vomiting ( =0.000 3, =0.43, 95% =[0.28, 0.68]) and abdominal distention ( =0.000 5, =0.41, 95% =[0.25, 0.68]).

CONCLUSION

Acupuncture and moxibustion can promote the recovery of postoperative gastrointestinal function in the patients with gastric cancer. But, for the comparison among different measures of acupuncture and moxibustion intervention, it needs more high-quality trials for a further verification.

摘要

目的

采用Meta分析系统评价针灸治疗胃癌术后胃肠功能障碍(GID)的疗效。

方法

检索PubMed、EMbase、Cochrane临床对照试验中心注册库(CENTRAL)、中国知网(CNKI)、万方数据库、维普数据库和中国生物医学文献数据库(SinoMed)中自建库至2020年12月31日关于针灸治疗胃癌术后GID的随机对照试验(RCT)文献。采用RevMan5.3软件进行Meta分析。运用Stata16.0软件进行敏感性分析和发表偏倚检验。

结果

最终纳入16项RCT,共1360例患者,其中干预组681例,对照组679例。Meta分析结果显示,针灸可缩短首次排气时间(<0.000 01,MD=-14.52,95%CI=[-17.31,-11.74])、首次肠鸣音时间(<0.000 01,MD=-10.50,95%CI=[-13.99,-7.01])和首次排便时间(<0.000 1,MD=-13.79,95%CI=[-20.09,-7.50])。同时,针灸可缩短胃癌术后首次进食时间(<0.000 1,MD=-3.23,95%CI=[-3.45,-3.00])和住院时间(<0.000 01,MD=-1.94,95%CI=[-2.20,-1.69]),并降低术后恶心呕吐(P=0.000 3,RR=0.43,95%CI=[0.28,0.68])和腹胀(P=0.000 5,RR=0.41,95%CI=[0.25,0.68])等不良反应的发生率。

结论

针灸可促进胃癌患者术后胃肠功能恢复。但对于不同针灸干预措施之间的比较,尚需更多高质量试验进一步验证。

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