School of Pharmacy, China Medical University, Shenyang, 110122, China; Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
J Ethnopharmacol. 2023 Dec 5;317:116791. doi: 10.1016/j.jep.2023.116791. Epub 2023 Jun 26.
Ginger has been proposed for prevention of postoperative nausea and vomiting (PONV), however it remains equivocal whether ginger can be an alternative option and which certain preparation is optimal for PONV prophylaxis.
We conducted a network meta-analysis (NMA) to compare and rank relative efficacy for PONV control among all available ginger preparations collected in the databases.
Eligible records were identified by retrieving Medline (via Pubmed), Embase, Web of Science, CENTRAL, CNKI, WHO ICTRP and ClinicalTrials.gov for randomized controlled trials that investigated the efficacy of ginger therapies for the prophylaxis of PONV. A bayesian NMA within random-effects models was implemented. Certainty of evidence for estimates was investigated following GRADE framework. We prospectively registered the protocol (CRD 42021246073) in PROSPERO.
Eighteen publications comprising 2199 participants with PONV were identified. Ginger oil (RR [95%CI], 0.39 [0.16, 0.96]) appeared to have the highest probability of being ranked best to decrease the incidence of postoperative vomiting (POV), with statistical significance compared with placebo, based on high to moderate confidence in estimates. With regard to reducing postoperative nausea (PON), statistically superiority was not observed in ginger regimens compared with placebo based on moderate to low certainty of evidence. Reduction in antemetic use and nausea intensity were noticed in ginger powder and oil. Ginger was significantly associated with better efficacy for Asian, older age, higher dosage, preoperative administration, hepatobiliary and gastrointestinal surgery.
Ginger oil appeared to be superior to other ginger treatments for the prophylaxis of POV. With regard to reducing PON, ginger preparations indicated no obvious advantages.
生姜已被提议用于预防术后恶心和呕吐（PONV），但生姜是否可以作为替代选择，以及哪种特定制剂最适合预防 PONV 仍然存在争议。
我们进行了一项网络荟萃分析（NMA），以比较和评估所有可用于预防 PONV 的生姜制剂的相对疗效。
通过检索 Medline（通过 Pubmed）、Embase、Web of Science、CENTRAL、CNKI、WHO ICTRP 和 ClinicalTrials.gov 来识别符合条件的记录，这些数据库中收录了关于生姜疗法预防 PONV 疗效的随机对照试验。采用随机效应模型进行贝叶斯 NMA。按照 GRADE 框架评估估计的证据确定性。我们前瞻性地在 PROSPERO 中注册了方案（CRD 42021246073）。
共确定了 18 篇文献，涉及 2199 名 PONV 患者。生姜油（RR [95%CI]，0.39 [0.16, 0.96]）似乎最有可能被评为预防术后呕吐（POV）的最佳药物，与安慰剂相比，基于对估计的高度到中度置信度，具有统计学意义。至于减少术后恶心（PON），基于中等到低确定性证据，生姜方案与安慰剂相比没有观察到统计学优势。生姜粉和油可减少止吐药物的使用和恶心程度。生姜与亚洲人、年龄较大、剂量较高、术前给药、肝胆和胃肠道手术的疗效改善显著相关。
生姜油似乎优于其他生姜治疗方案，用于预防 POV。至于减少 PON，生姜制剂没有明显优势。
