Cheong Kah Bik, Zhang Jiping, Huang Yong
J Tradit Chin Med. 2016 Jun;36(3):271-82. doi: 10.1016/s0254-6272(16)30038-3.
To conduct a systematic review and Meta-analysis of the effectiveness of acupuncture and common acupoint selection for postoperative ileus (POI).
Randomized controlled trials (RCTs) comparing acupuncture and non-acupuncture treatment were identified from the databases PubMed, Cochrane, EBSCO (Academic Source Premier and MEDLINE), Ovid (including Evidence-Based Medicine Reviews), China National Knowledge Infrastructure, and Wanfang Data. The data from eligible studies were extracted and a Meta-analysis performed using a fixed-effects model. Results were expressed as relative risk (RR) for dichotomous data, and 95% CI (confidence intervals) were calculated. Each trial was evaluated using the CONSORT (Consolidated Standards of Reporting Trials) and STRICTA (STandards for Reporting Interventions in Controlled Trials of Acupuncture) guideline . The quality of the study was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Of the 69 studies screened, eight RCTs were included for review. Among these, four RCTs (with a total of 123 patients in the intervention groups and 124 patients in the control groups) met the criteria for Meta-analysis. The Meta-analysis results indicated that acupuncture combined with usual care showed a significantly higher total effective rate than the control condition (usual care) (RR 1.09, 95% CI 1.01, 1.18; P = 0.02). Zusanli (ST 36) and Shangjuxu (ST 37) were the most common acupoints selected. However, the quality of the studies was generally low, as they did not emphasize the use of blinding.
The results suggested that acupuncture might be effective in improving POI; however, a definite conclusion could not be drawn because of the low quality of trials. Further large-scale, high-quality randomized clinical trials are needed to validate these findings and to develop a standardized method of treatment. We hope that the present results will lead to improved research, resulting in better patient care worldwide.
对针刺及常用穴位选择治疗术后肠梗阻（POI）的有效性进行系统评价和Meta分析。
从PubMed、Cochrane、EBSCO（学术期刊大全和医学期刊数据库）、Ovid（包括循证医学评价）、中国知网和万方数据等数据库中检索比较针刺与非针刺治疗的随机对照试验（RCT）。提取符合条件研究的数据，并采用固定效应模型进行Meta分析。二分类数据结果以相对危险度（RR）表示，并计算95%置信区间（CI）。每项试验均按照CONSORT（试验报告统一标准）和STRICTA（针刺对照试验干预报告标准）指南进行评估。采用推荐分级、评估、制定与评价（GRADE）方法评估研究质量。
在筛选的69项研究中，纳入8项RCT进行综述。其中，4项RCT（干预组共123例患者，对照组共124例患者）符合Meta分析标准。Meta分析结果表明，针刺联合常规护理的总有效率显著高于对照组（常规护理）（RR 1.09，95%CI 1.01，1.18；P = 0.02）。足三里（ST 36）和上巨虚（ST 37）是最常用的穴位。然而，研究质量普遍较低，因为它们没有强调使用盲法。
结果提示针刺可能对改善POI有效；然而，由于试验质量较低未能得出确切结论。需要进一步开展大规模、高质量的随机临床试验来验证这些发现并制定标准化治疗方法。我们希望目前的结果将推动研究改进，从而在全球范围内为患者提供更好的护理。
