Chen Hsiao-Tien, Hung Kuo-Chuan, Hsu Yao-Chin, Kuo Jinn-Rung, Chang Ying-Jen, Chen I-Wen, Sun Cheuk-Kwan
Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
Front Med (Lausanne). 2023 Jun 2;10:1114485. doi: 10.3389/fmed.2023.1114485. eCollection 2023.
This meta-analysis aimed at investigating the efficacy of acupuncture for pain relief in patients receiving extracorporeal shock wave lithotripsy (ESWL).
Randomized controlled trials comparing the efficacy of acupuncture with conventional treatments were retrieved from major electronic databases (e.g., MEDLINE, EMBASE, and Cochrane Library) until August 28, 2022. The primary outcome was the response rate (i.e., rate of pain relief), while secondary outcomes included stone-free rate, satisfaction rate, duration of ESWL, peri-/post-procedural pain score, and risk of adverse events.
Thirteen eligible studies involving 1,220 participants published between 1993 and 2022 were analyzed. Pooled results indicated that acupuncture had a better response rate compared to conventional treatments (RR = 1.17, 95% CI: 1.06-1.3, = 0.003, seven trials, = 832). Despite no difference in ESWL duration (MD = 0.02 min, 95% CI: -1.53 to 1.57, = 0.98, three trials, = 141), stone-free rate (RR = 1.11, 95% CI: 1-1.25, = 0.06, six trials, = 498), and satisfaction rate (RR = 1.51, 95% CI: 0.92-2.47, = 0.1, three trials, = 334) between the two groups, the acupuncture group had a lower risk of adverse events (RR = 0.51, 95% CI: 0.33-0.79, = 0.003, five trials, = 327), peri- (MD = -1.91 points, 94% CI: -3.53 to -0.28, = 0.02, four trials, = 258 patient) and post-procedural (MD = -1.07, 95% CI: -1.77 to -0.36, = 0.003, four trials, = 335) pain score.
The results of this meta-analysis showed that the use of acupuncture in patients receiving ESWL was associated with a higher pain relief rate and a lower risk of adverse events, suggesting feasibility of its use in this clinical setting.
https://www.crd.york.ac.uk/prospero/, identifier: CRD42022356327.
本荟萃分析旨在研究针刺对接受体外冲击波碎石术（ESWL）患者的止痛效果。
从主要电子数据库（如MEDLINE、EMBASE和Cochrane图书馆）检索截至2022年8月28日比较针刺与传统治疗效果的随机对照试验。主要结局是缓解率（即疼痛缓解率），次要结局包括结石清除率、满意率、ESWL持续时间、围手术期/术后疼痛评分以及不良事件风险。
分析了1993年至2022年间发表的13项符合条件的研究，共1220名参与者。汇总结果表明，与传统治疗相比，针刺的缓解率更高（RR = 1.17，95%CI：1.06 - 1.3，P = 0.003，7项试验，n = 832）。尽管两组在ESWL持续时间（MD = 0.02分钟，95%CI： - 1.53至1.57，P = 0.98，3项试验，n = 141）、结石清除率（RR = 1.11，95%CI：1 - 1.25，P = 0.06，6项试验，n = 498）和满意率（RR = 1.51，95%CI：0.92 - 2.47，P = 0.1，3项试验，n = 334）方面无差异，但针刺组不良事件风险较低（RR = 0.51，95%CI：0.33 - 0.79，P = 0.003，5项试验，n = 327），围手术期（MD = - 1.91分，94%CI： - 3.53至 - 0.28，P = 0.02，4项试验，n = 258例患者）和术后疼痛评分（MD = - 1.07，95%CI： - 1.77至 - 0.36，P = 0.003，4项试验，n = 335）较低。
本荟萃分析结果表明，针刺用于接受ESWL的患者与更高的疼痛缓解率和更低的不良事件风险相关，提示其在该临床环境中的应用可行性。
