Department of Emergency, Xingtai People's Hospital of Hebei Province, Xingtai, China.
Rehabilitation Department of Traditional Chinese Medicine, Xingtai People's Hospital of Hebei Province, Xingtai, China.
Ann Palliat Med. 2021 Nov;10(11):11840-11848. doi: 10.21037/apm-21-3046.
Postoperative gastrointestinal dysfunction (PGD) leading to nausea, vomiting, and abdominal distension are common complications after laparoscopic surgery for abdominal diseases. However, drugs cannot completely stop PGD. Over the years, transcutaneous electrical acupoint stimulation (TEAS) therapy has shown potential in preventing PGD, but there is no medical evidence that TEAS represents the best choice for the treatment of PGD. This network meta-analysis sought to evaluate the effectiveness of TEAS therapy in preventing PGD in patients after abdominal laparoscopic surgery.
Articles (published from the establishment of the databases to July 2021) were retrieved from the following databases: PubMed/Medline, Cochrane Library, Web of Science, Embase, China Biomedical Literature Database (CBM), China Technical Journal VIP Database (CQVIP), China Knowledge Infrastructure (CNKI), and the Wanfang Database. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and a network meta-analysis was performed using RevMan 5.20.
A total of 7 randomized controlled trials, comprising 440 TEAS-treated patients and 468 control patients, were included in the meta-analysis. The meta-analysis showed that there was no significant difference between the TEAS treatment group and the control group in relation to postoperative nausea and vomiting [relative risk (RR) =0.66; 95% confidence interval (CI): 0.37-1.21; P=0.18], postoperative abdominal distension (RR =0.53; 95% CI: 0.40-0.72; P<0.0001), the time of first postoperative fart (imply gastrointestinal motility) [mean difference (MD) =-7.31; 95% CI: -11.33 to -3.30; P=0.0004], and the time of first postoperative bowel movement (MD =-5.28; 95% CI: -7.23 to -3.33; P<0.0001); there were significant differences among these 3 indicators.
We found that TEAS can promote postoperative fart and bowel movement, and has good clinical value in promoting postoperative gastrointestinal function recovery.
术后胃肠功能障碍（PGD）导致恶心、呕吐和腹胀是腹部疾病腹腔镜手术后常见的并发症。然而，药物并不能完全阻止 PGD。多年来，经皮穴位电刺激（TEAS）疗法在预防 PGD 方面显示出了潜力，但没有医学证据表明 TEAS 是治疗 PGD 的最佳选择。本网络荟萃分析旨在评估 TEAS 疗法预防腹部腹腔镜手术后患者 PGD 的有效性。
从各数据库建立至 2021 年 7 月检索文献，包括 PubMed/Medline、Cochrane 图书馆、Web of Science、Embase、中国生物医学文献数据库（CBM）、中国科技期刊全文数据库 VIP（CQVIP）、中国知识基础设施（CNKI）和万方数据库。使用 Cochrane 偏倚风险工具评估纳入研究的质量，并使用 RevMan 5.20 进行网络荟萃分析。
共纳入 7 项随机对照试验，包括 440 例 TEAS 治疗患者和 468 例对照组患者。荟萃分析显示，TEAS 治疗组与对照组在术后恶心呕吐方面无显著差异[相对风险（RR）=0.66；95%置信区间（CI）：0.37-1.21；P=0.18]、术后腹胀（RR=0.53；95%CI：0.40-0.72；P<0.0001）、首次术后放屁（胃肠蠕动）的时间[平均差（MD）=-7.31；95%CI：-11.33 至-3.30；P=0.0004]和首次术后排便时间（MD=-5.28；95%CI：-7.23 至-3.33；P<0.0001）；这 3 个指标之间存在显著差异。
我们发现 TEAS 可以促进术后放屁和排便，在促进术后胃肠功能恢复方面具有良好的临床价值。
