Yin Zihan, Xiao Qiwei, Xu Guixing, Cheng Ying, Yang Han, Zhou Jun, Fu Yanan, Chen Jiao, Zhao Ling, Liang Fanrong
School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
Evid Based Complement Alternat Med. 2020 Jul 30;2020:7509481. doi: 10.1155/2020/7509481. eCollection 2020.
Postcholecystectomy syndrome (PCS) has become a common postoperative syndrome that requires systematic and comprehensive therapy to achieve adequate clinical control. Acupuncture and related therapies have shown clinical effects for PCS in many studies. However, systematic reviews/meta-analyses (SRs/MAs) for them are lacking.
To evaluate the efficacy and safety of acupuncture in the treatment of PCS using randomized controlled trials (RCTs).
Potentially eligible studies were searched in the following electronic databases up to 1 February 2020: PubMed, Embase, Cochrane Library, Web of Science (WoS), Chinese databases (Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and China Science and Technology Journal Database (VIP)), and other sources (WHO ICTRP, ChiCTR, Clinical Trials, and Grey Literature Database). The RevMan 5.3 was employed for analyses. The Cochrane Collaboration' risk of bias tool was used to assess the risk of bias (ROB). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence.
A total of 14 RCTs with 1593 participants were included in this SR. MA showed that acupuncture in combination with conventional medicine (CM) did not show statistical differences in reduction in pain. However, acupuncture in combination with CM significantly reduced the incidence of postoperative nausea and vomiting (PONV) (RR, 0.71; 95% CI, 0.55-0.92) and improved gastrointestinal function recovery compared to the CM group. Acupuncture combined with traditional Chinese medicine and CM, and acupuncture as monotherapy may improve gastrointestinal function recovery with acceptable adverse events.
Acupuncture may be an effective and safe treatment for PCS. However, this study lacks conclusive evidence due to poor quality evidence, limited data, and clinical heterogeneity of acupuncture methods in the included studies.
胆囊切除术后综合征（PCS）已成为一种常见的术后综合征，需要系统全面的治疗以实现充分的临床控制。许多研究表明针灸及相关疗法对PCS有临床疗效。然而，目前缺乏针对它们的系统评价/荟萃分析（SRs/MAs）。
采用随机对照试验（RCTs）评估针灸治疗PCS的疗效和安全性。
截至2020年2月1日，在以下电子数据库中检索潜在符合条件的研究：PubMed、Embase、Cochrane图书馆、科学引文索引（WoS）、中文数据库（中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库（WF）和中国科技期刊数据库（VIP））以及其他来源（世界卫生组织国际临床试验注册平台（WHO ICTRP）、中国临床试验注册中心（ChiCTR）、临床试验和灰色文献数据库）。采用RevMan 5.3进行分析。使用Cochrane协作网偏倚风险工具评估偏倚风险（ROB）。采用推荐分级评估、制定与评价（GRADE）方法评估证据质量。
本系统评价共纳入14项RCTs，1593名参与者。荟萃分析表明，针灸联合传统医学（CM）在减轻疼痛方面无统计学差异。然而，与CM组相比，针灸联合CM显著降低了术后恶心呕吐（PONV）的发生率（RR，0.71；95%CI，0.55 - 0.92），并改善了胃肠功能恢复。针灸联合中药和CM以及单纯针灸治疗可能改善胃肠功能恢复，且不良事件可接受。
针灸可能是一种治疗PCS的有效且安全的方法。然而，由于证据质量差、数据有限以及纳入研究中针灸方法的临床异质性，本研究缺乏确凿证据。
