针刺在胃肠内镜检查中的镇静节省效应：系统评价与荟萃分析
Sedative-sparing effect of acupuncture in gastrointestinal endoscopy: systematic review and meta-analysis.
作者信息
Yang Yun, Ji Haiyang, Lu Yunqiong, Hong Jue, Yang Guang, Kong Xiehe, Liu Jie, Ma Xiaopeng
机构信息
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
出版信息
Front Med (Lausanne). 2023 Jun 16;10:1189429. doi: 10.3389/fmed.2023.1189429. eCollection 2023.
OBJECTIVE
This study aimed to perform a systematic review and meta-analysis to identify the efficacy of acupuncture therapy (including manual acupuncture and electroacupuncture) performed before or during gastrointestinal endoscopy with propofol as the main sedative, compared with placebo, sham acupuncture, or no additional treatment other than the same sedation.
METHODS
A systematic search was performed through PubMed, Embase, Web of Science, Cochrane Library, Chinese Biomedical Databases (CBM), Wanfang database, China National Knowledge Infrastructure (CNKI), SinoMed, and Chinese Scientific Journal Database (VIP) to collect randomized controlled trials published before 5 November 2022. Bias assessment of the included RCTs was performed according to Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). Stata16.0 software was used to perform statistical analysis, sensitivity analysis, and publication bias analysis. The primary outcome was sedative consumption, and the secondary outcomes included the incidence of adverse events and wake-up time.
RESULTS
A total of 10 studies with 1331 participants were included. The results showed that sedative consumption [mean difference (MD) = -29.32, 95% CI (-36.13, -22.50), < 0.001], wake-up time [MD = -3.87, 95% CI (-5.43, -2.31), < 0.001] and the incidence of adverse events including hypotension, nausea and vomiting, and coughing ( < 0.05) were significantly lower in the intervention group than in the control group.
CONCLUSION
Acupuncture combined with sedation reduces sedative consumption and wake-up time compared with sedation alone in gastrointestinal endoscopy; this combined approach allows patients to regain consciousness more quickly after examination and lower the risk of adverse effects. However, with the limited quantity and quality of relevant clinical studies, caution must be applied until more high-quality clinical studies verify and refine the conclusions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?, identifier: CRD42022370422.
目的
本研究旨在进行系统评价和荟萃分析，以确定在以丙泊酚为主要镇静剂的胃肠内镜检查前或检查期间进行针刺治疗（包括手针和电针）与安慰剂、假针刺或除相同镇静外不进行额外治疗相比的疗效。
方法
通过PubMed、Embase、Web of Science、Cochrane图书馆、中国生物医学数据库（CBM）、万方数据库、中国知网（CNKI）、中国生物医学文献服务系统（SinoMed）和维普中文科技期刊数据库（VIP）进行系统检索，以收集2022年11月5日前发表的随机对照试验。根据Cochrane随机试验偏倚风险工具第2版（RoB 2）对纳入的随机对照试验进行偏倚评估。使用Stata16.0软件进行统计分析、敏感性分析和发表偏倚分析。主要结局是镇静剂消耗量，次要结局包括不良事件发生率和苏醒时间。
结果
共纳入10项研究，1331名参与者。结果显示，干预组的镇静剂消耗量[平均差（MD）=-29.32，95%可信区间（-36.13，-22.50），P<0.001]、苏醒时间[MD=-3.87，95%可信区间（-5.43，-2.31），P<0.001]以及包括低血压、恶心呕吐和咳嗽在内的不良事件发生率（P<0.05）均显著低于对照组。
结论
与胃肠内镜检查单纯镇静相比，针刺联合镇静可减少镇静剂消耗量和苏醒时间；这种联合方法可使患者在检查后更快恢复意识，并降低不良反应风险。然而，鉴于相关临床研究的数量和质量有限，在更多高质量临床研究验证并完善结论之前，必须谨慎应用。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?，标识符：CRD42022370422。
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