Gao Ning, Chen Huan, Wang Yang, Guo Yufeng, Liu Zhishun, Wang Weiming
Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Front Med (Lausanne). 2022 Jun 3;9:865035. doi: 10.3389/fmed.2022.865035. eCollection 2022.
Severe discomfort during an upper gastrointestinal endoscopy (UGE) is often a stressful experience for patients undergoing the procedure. An increasing number of studies have shown that acupuncture may reduce discomfort during UGE. A systematic review in 2004 investigated the effect of acupuncture for gastrointestinal endoscopy, but these data have not been recently reviewed. Therefore, this study was conducted to evaluate the current evidence and provide up-to-date knowledge for clinical decision-making.
Nine databases were searched from inception to June 2021. Eligible randomized controlled trials (RCTs) were included. The outcome data were synthesized where necessary, and risks of bias of included studies were assessed using RevMan V.5.3.
Twenty-three eligible RCTs with 3,349 patients were identified. It was found that acupuncture plus topical pharyngeal anesthesia with lidocaine hydrochloride (TPALH) resulted in greater improvements regarding visual analog scale (VAS) scores and the incidence of nausea and vomiting (INV) when compared with TPALH alone. These results were consistent among studies of manual acupuncture, electroacupuncture, auricular-plaster, superficial needle (SFN) and acupressure. In the meta-analysis, SFN plus TPALH showed significant improvement of VAS scores compared to sham SFN plus TPALH (MD -1.11, 95% CI -1.52 to -0.70, < 0.00001). Most of included studies did not report any side effects in their findings, and were of medium-to-high risk of bias.
Acupuncture, as adjunctive therapy to TPA, may result in less patient discomfort than TPA alone. Findings from this review should be interpreted with caution due to the high heterogeneity identified. There is low-quality evidence supporting the use of acupuncture over sham. More rigorously designed RCTs are needed to inform clinical decision-making.
PROSPERO [CRD42014008966].
上消化道内镜检查（UGE）期间的严重不适对接受该检查的患者来说通常是一次充满压力的经历。越来越多的研究表明，针灸可能会减轻UGE期间的不适。2004年的一项系统评价研究了针灸对胃肠内镜检查的效果，但这些数据最近未被重新审视。因此，本研究旨在评估当前证据，并为临床决策提供最新知识。
检索了9个数据库，检索时间从建库至2021年6月。纳入符合条件的随机对照试验（RCT）。必要时对结果数据进行综合分析，并使用RevMan V.5.3评估纳入研究的偏倚风险。
共识别出23项符合条件的RCT，涉及3349例患者。结果发现，与单独使用盐酸利多卡因局部咽部麻醉（TPALH）相比，针灸联合TPALH在视觉模拟量表（VAS）评分以及恶心呕吐发生率（INV）方面有更大改善。这些结果在手动针刺、电针、耳穴贴压、浅针（SFN）和指压的研究中是一致的。在荟萃分析中，与假浅针联合TPALH相比，浅针联合TPALH在VAS评分上有显著改善（MD -1.11，95%CI -1.52至-0.70，P<0.00001）。大多数纳入研究在其结果中未报告任何副作用，且偏倚风险为中到高。
针灸作为TPA的辅助治疗，可能比单独使用TPA导致患者不适更少。由于发现存在高度异质性，本综述的结果应谨慎解释。支持使用针灸而非假针灸的证据质量较低。需要更严格设计的RCT来为临床决策提供依据。
PROSPERO [CRD42014008966]
