Chen Hsiao-Tien, Kuo Cheng-Feng, Hsu Chin-Chia, Lai Li-Chun, Cheng Ai-Chin, Sun Cheuk-Kwan, Hung Kuo-Chuan
Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan.
Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan.
Front Med (Lausanne). 2023 Jan 9;9:1100014. doi: 10.3389/fmed.2022.1100014. eCollection 2022.
This meta-analysis aimed at investigating the efficacy of acupuncture for relieving renal colic and reducing the risk of analgesic-related complications.
Randomized controlled trials (RCTs) comparing the efficacy of acupuncture (acupuncture group) with conventional interventions (control group) were screened from MEDLINE, EMBASE, Cochrane library databases, China Knowledge Network (CNKI), and Airiti Library till July 15, 2022. The primary outcome was the rate of effective pain relief (response rate), while secondary outcomes included the time of onset of pain relief, visual analog scale (VAS) at 30-60 min and risk of side effects.
Thirteen eligible studies involving 1,212 participants published between 1992 and 2021 were analyzed. Compared with the control group, patients receiving acupuncture had a higher overall response rate [risk ratio (RR) = 1.12, 95% CI: 1.05-1.19, = 0.0002, = 41%, 1,136 patients] (primary outcome) and a faster pain relief [MD = -10.74 min, 95% CI: -12.65 to -8.82, < 0.00001, = 87%, 839 patients]. Patients receiving acupuncture had a lower pain score [MD = -0.65, 95% CI: -1.09 to -0.21, = 0.21, = 55%, 327 patients] and risk of side effects (RR = 0.11, 95% CI: 0.04-0.26, < 0.00001, = 0, 314 patients) compared to those receiving conventional interventions. Results from trial sequence analysis revealed sufficient evidence supporting the beneficial effects of acupuncture on response rate, time to pain relief, and pain score at 30-60 min.
Compared with conventional analgesic-based interventions, acupuncture can more efficiently relieve renal colic with fewer adverse effects. The limited number and quality of included studies warrant more clinical RCTs to support our findings.
https://www.crd.york.ac.uk/prospero/, identifier CRD42022346714.
本荟萃分析旨在研究针刺缓解肾绞痛及降低镇痛相关并发症风险的疗效。
从MEDLINE、EMBASE、Cochrane图书馆数据库、中国知网(CNKI)和华艺数位图书馆中筛选出比较针刺(针刺组)与传统干预措施(对照组)疗效的随机对照试验(RCT),检索截至2022年7月15日。主要结局为有效疼痛缓解率(反应率),次要结局包括疼痛缓解开始时间、30 - 60分钟时的视觉模拟评分(VAS)及副作用风险。
分析了1992年至2021年间发表的13项符合条件的研究,共涉及1212名参与者。与对照组相比,接受针刺治疗的患者总体反应率更高[风险比(RR)= 1.12,95%置信区间:1.05 - 1.19,P = 0.0002,I² = 41%,1136例患者](主要结局),疼痛缓解更快[平均差值(MD)= -10.74分钟,95%置信区间:-12.65至-8.82,P < 0.00001,I² = 87%,839例患者]。与接受传统干预措施的患者相比,接受针刺治疗的患者疼痛评分更低[MD = -0.65,95%置信区间:-1.09至-0.21,P = 0.21,I² = 55%,327例患者],副作用风险更低(RR = 0.11,95%置信区间:0.04 - 0.26,P < 0.00001,I² = 0,314例患者)。试验序贯分析结果显示,有充分证据支持针刺在反应率、疼痛缓解时间及30 - 60分钟时疼痛评分方面的有益作用。
与基于传统镇痛的干预措施相比,针刺能更有效地缓解肾绞痛,且副作用更少。纳入研究的数量和质量有限,需要更多的临床随机对照试验来支持我们的研究结果。