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围手术期针灸能否减轻扁桃体切除术后的疼痛和呕吐?一项荟萃分析。

Can perioperative acupuncture reduce the pain and vomiting experienced after tonsillectomy? A meta-analysis.

作者信息

Cho Hye Kyung, Park In Joon, Jeong Yeon Min, Lee Yeon Ji, Hwang Se Hwan

机构信息

Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Republic of Korea.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Laryngoscope. 2016 Mar;126(3):608-15. doi: 10.1002/lary.25721. Epub 2015 Oct 20.

Abstract

OBJECTIVES

Acupuncture has been shown to reduce pain, nausea, and vomiting. However, its use alongside surgical interventions remains a novel practice, despite the increasing applications of alternative medicine. The goal of this meta-analysis was to perform a systematic review of the literature addressing the effect of acupuncture on postoperative pain, nausea, and vomiting following tonsillectomy.

DATA SOURCES

MEDLINE, SCOPUS, and Cochrane database.

METHODS

Two authors independently searched the databases from the inception of article collection until June 2015. We included 1) analysis studies that compared groups of patients who had received perioperative acupuncture (acupuncture groups) with those who had received a pain control agent or sham treatment (control group); and 2) analysis studies in which the outcomes of interest were postoperative pain intensity, rescue analgesic consumption, or nausea and vomiting.

RESULTS

The pain score reported by patients during the first 48 hours and the postoperative need for analgesics were significantly lower in the acupuncture group versus the control group. Additionally, the incidence of postoperative nausea and vomiting was significantly lower in the acupuncture group than in the control group. No major adverse effects of perioperative acupuncture were reported in the enrolled studies.

CONCLUSION

Perioperative acupuncture may provide pain relief without side effects in patients undergoing tonsillectomy. However, there were high levels of heterogeneity in several of the measured parameters; thus, the efficacy of acupuncture cannot be considered to have been evaluated sufficiently. For this reason, additional large well-designed trials are required to further support the results of this study.

LEVEL OF EVIDENCE

NA. Laryngoscope, 126:608-615, 2016.

摘要

目的

针灸已被证明可减轻疼痛、恶心和呕吐。然而,尽管替代医学的应用日益广泛,但将其与手术干预同时使用仍是一种新的做法。本荟萃分析的目的是对有关针灸对扁桃体切除术后疼痛、恶心和呕吐影响的文献进行系统综述。

数据来源

MEDLINE、SCOPUS和Cochrane数据库。

方法

两位作者独立检索了从文章收集开始至2015年6月的数据库。我们纳入了1)分析研究,这些研究比较了接受围手术期针灸治疗的患者组(针灸组)与接受疼痛控制药物或假治疗的患者组(对照组);以及2)分析研究,其中感兴趣的结果是术后疼痛强度、急救镇痛药的使用量或恶心和呕吐情况。

结果

与对照组相比,针灸组患者在术后48小时内报告的疼痛评分以及术后对镇痛药的需求显著更低。此外,针灸组术后恶心和呕吐的发生率明显低于对照组。在纳入的研究中未报告围手术期针灸的重大不良反应。

结论

围手术期针灸可能为接受扁桃体切除术的患者提供无副作用的疼痛缓解。然而,在几个测量参数中存在高度异质性;因此,不能认为针灸的疗效已得到充分评估。出于这个原因,需要更多设计良好的大型试验来进一步支持本研究的结果。

证据级别

无。《喉镜》,2016年,第126卷,第608 - 615页。

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