Lu Haizhen, Zheng Chengwen, Zhong Yanmei, Cheng Linhao, Zhou Yi
School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
School of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Evid Based Complement Alternat Med. 2021 Jul 27;2021:2731446. doi: 10.1155/2021/2731446. eCollection 2021.
Hyperemesis gravidarum (HG) is a common gastrointestinal disease afflicting gravidas. It usually results in hospital admission in early pregnancy.
Through a meta-analysis, this study intended to explore acupuncture's clinical efficacy in treating HG.
A comprehensive search of PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang Database, and China Science and Technology Journal (VIP) for published clinical randomized controlled trials (RCTs) of acupuncture for treating HG was conducted from the date of database creation to 20th January 2021. We also searched grey literature in four databases: Chinese Cochrane Center, Chinese Clinical Trial Registry, GreyNet International, and Open Grey from their inception to 20th January 2021. Two authors independently screened the literature, extracted data, and evaluated the quality of the literature with Cochrane Handbook 5.1.0 and Review Manager 5.2 software. Review Manager 5.2 and STATA 12.0 software were applied to analyze data. Heterogeneity analysis was performed by the Cochran Chi-square test and statistic. Egger's tests together with funnel plots were used to identify publication bias.
A total of 16 trials covering 1043 gravidas were included. Compared with the conventional treatment, acupuncture had a significantly higher effective rate (OR: 8.11, 95% CI: 5.29∼12.43; < 0.00001), a higher conversion rate of urine ketone (RR: 1.36, 95% CI: 1.15∼1.60; =0.0003), an improvement rate of nausea and vomiting (OR: 26.44, 95% CI: 3.54∼197.31; =0.001), and a relatively higher improvement rate of food intake (RR: 1.17, 95% CI: 1.01∼1.36; =0.04). Acupuncture also shortened hospitalization time and manifested with a lower pregnancy termination rate and fewer adverse events. Nevertheless, no statistical variation in the improvement of nausea intensity, vomiting episodes, and lassitude symptom, recurrence rate, and serum potassium was observed.
Our study suggested that acupuncture was effective in treating HG. However, as the potential inferior quality and underlying publication bias were found in the included studies, there is a need for more superior-quality RCTs to examine their effectiveness and safety. PROSPERO registration number: CRD42021232187.
妊娠剧吐（HG）是一种困扰孕妇的常见胃肠道疾病。它通常导致孕早期住院。
通过荟萃分析，本研究旨在探讨针刺治疗妊娠剧吐的临床疗效。
从数据库创建之日至2021年1月20日，全面检索了PubMed、Cochrane图书馆、EMBASE、Web of Science、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方数据库和维普中文科技期刊数据库（VIP），以查找已发表的针刺治疗妊娠剧吐的临床随机对照试验（RCT）。我们还在四个数据库中检索了灰色文献：中国Cochrane中心、中国临床试验注册中心、GreyNet国际和Open Grey，检索时间从其创建之初至2021年1月20日。两名作者独立筛选文献、提取数据，并使用Cochrane手册5.1.0和Review Manager 5.2软件评估文献质量。应用Review Manager 5.2和STATA 12.0软件进行数据分析。采用Cochran卡方检验和I²统计量进行异质性分析。使用Egger检验和漏斗图识别发表偏倚。
共纳入16项试验，涉及1043名孕妇。与传统治疗相比，针刺的有效率显著更高（OR：8.11，95%CI：5.29～12.43；P＜0.00001），尿酮转化率更高（RR：1.36，95%CI：1.15～1.60；P = 0.0003），恶心呕吐改善率更高（OR：26.44，95%CI：3.54～197.31；P = 0.001），食物摄入量改善率相对更高（RR：1.17，95%CI：1.01～1.36；P = 0.04）。针刺还缩短了住院时间，表现为较低的流产率和较少的不良事件。然而，在恶心强度、呕吐发作次数、乏力症状改善、复发率和血清钾方面未观察到统计学差异。
我们的研究表明针刺治疗妊娠剧吐有效。然而，由于纳入研究中存在潜在的质量较差和潜在的发表偏倚，需要更多高质量的RCT来检验其有效性和安全性。PROSPERO注册号：CRD42021232187。
