Beijing Dongzhismen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
Department of Integration of Chinese and Western Medicine, Key Laboratory of Carcinogen esis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China.
J Tradit Chin Med. 2022 Aug;42(4):505-512. doi: 10.19852/j.cnki.jtcm.2022.04.002.
To evaluate the clinical effectiveness and safety of electroacupuncture for treating pain after laparoscopic surgery.
The following databases were searched (since their establishment until November 16, 2021) for randomized controlled trials (RCTs) on electro-acupuncture for pain after laparoscopic surgery: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, and Chinese Biomedical Literature Database. Data were screened independently and extracted by two reviewers. Two researchers independently extracted and cross-checked data and applied the modified Jadad scale and the Cochrane-recommended assessment method to evaluate the bias risk. The Meta-analysis was conducted using RevMan5.3 software.
Twelve RCTs enrolling 788 patients were included. (a) For postoperative 24 h visual analogue scale, five trials were included on electroacupuncture + routine analgesia therapy vs routine analgesia therapy with significance in electroacupuncture conducted after surgery [mean difference (MD) = -0.63, 95% confidence interval (CI) (-0.90, -0.37)], as well as in electroacupuncture conducted before and after surgery [MD = -1.01, 95% CI (-1.62, -0.41)] and in surgery. However, two trials were included in electroacupuncture conducted 24 h before surgery with no significant difference [MD = -0.16, 95% CI (-0.44, 0.12)]. (b) The anesthetics intake of electroacupuncture + routine analgesia therapy vs. routine analgesia therapy was significant [MD = -121.71, 95% CI (-164.92, -78.49)]. (c) The adverse effects of electroacupuncture + routine analgesia therapy vs. routine analgesia therapy were significant both in the incidence of postoperative nausea and vomiting [risk rate (RR) = 0.49, 95% CI (0.39, 0.61)] and postoperative dizziness and headache [RR = 0.14, 95% CI (0.04, 0.47)].
The evidence showed that electro-acupuncture combined with routine analgesia therapy effectively treated pain after laparoscopic surgery. However, more rigorously designed RCTs are required due to the low quality of the included studies and the incomplete outcome evaluation system.
评估电针对腹腔镜手术后疼痛的临床疗效和安全性。
检索了以下数据库(自成立至 2021 年 11 月 16 日)中的随机对照试验(RCT),以评估电针对腹腔镜术后疼痛的疗效:PubMed、Embase、Cochrane 图书馆、Web of Science、中国知网数据库、万方数据库、中国科技期刊数据库和中国生物医学文献数据库。由两位评审员独立筛选和提取数据。两位研究人员独立提取和交叉核对数据,并应用改良 Jadad 量表和 Cochrane 推荐的评估方法评估偏倚风险。使用 RevMan5.3 软件进行 Meta 分析。
纳入了 12 项 RCT,共 788 名患者。(a)对于术后 24 h 视觉模拟评分,5 项试验将电针+常规镇痛疗法与常规镇痛疗法进行了比较,结果显示电针在手术后进行[差异(MD)=-0.63,95%置信区间(CI)(-0.90,-0.37)]以及在手术前后进行[MD=-1.01,95%CI(-1.62,-0.41)]均有统计学意义。然而,有 2 项试验将电针在手术前 24 h 进行,差异无统计学意义[MD=-0.16,95%CI(-0.44,0.12)]。(b)电针+常规镇痛疗法与常规镇痛疗法的麻醉剂摄入量有显著差异[MD=-121.71,95%CI(-164.92,-78.49)]。(c)电针+常规镇痛疗法与常规镇痛疗法的不良反应发生率在术后恶心呕吐[风险比(RR)=0.49,95%CI(0.39,0.61)]和术后头晕头痛[RR=0.14,95%CI(0.04,0.47)]方面均有显著差异。
证据表明,电针对腹腔镜手术后疼痛的治疗有效。然而,由于纳入研究的质量较低且结局评估系统不完整,需要更严格设计的 RCT 来进一步验证。