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针刺穴位刺激对围手术期睡眠障碍的影响:系统评价与荟萃分析及试验序贯分析。

Effects of Acupuncture-Point Stimulation on Perioperative Sleep Disorders: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.

机构信息

Department of Anaesthesiology, Hebei General Hospital, Shijiazhuang, China.

Hebei Medical University, Shijiazhuang, China.

出版信息

Int J Clin Pract. 2024 Jan 4;2024:6763996. doi: 10.1155/2024/6763996. eCollection 2024.

Abstract

BACKGROUND

Perioperative sleep disorders exert a severe adverse impact on postoperative recovery. Recently, some observational studies reported that acupuncture-point stimulation (APS) provided benefits for promoting perioperative sleep quality. However, the effects of APS on perioperative sleep disorders following general anesthesia have not been thoroughly assessed by any systematic study and meta-analysis. Therefore, we conducted this systematic review and meta-analysis to reveal the effects of APS on perioperative sleep disorders.

METHODS

Eight databases (Chinese: CNKI, VIP, CBM, and Wanfang; English: PubMed, Embase, Web of Science, and Cochrane Library) were thoroughly searched to find randomized controlled trials (RCTs) that indicated a link between APS and the occurrence of perioperative sleep disorders. We applied RevMan 5.4 (Cochrane Collaboration) and Stata 16.0 (Stata Corp) to conduct our meta-analysis. In addition, the trial sequential analysis (TSA) tool was utilized to estimate the validity and reliability of the data.

RESULTS

In this study, nine RCTs with 719 patients were conducted. Compared to the control group, APS significantly improved perioperative subjective sleep quality (SMD: -1.36; 95% CI: -1.71 to -1.01; < 0.00001). Besides, it increased perioperative TST (preoperative period MD = 24.29, 95% CI: 6.4 to 42.18, = 0.0008; postoperative period MD = 45.86, 95% CI: 30.00 to 61.71, < 0.00001) and SE (preoperative MD = 3.62, 95% CI: 2.84 to 4.39, < 0.00001; postoperative MD = 6.43, 95% CI: 0.95 to 11.73, < 0.00001). The consequence of trial sequential analysis further confirmed the reliability of our meta-analysis results.

CONCLUSION

According to the currently available evidence, APS could effectively improve perioperative sleep quality and play an essential role in decreasing the incidence of perioperative sleep disorders.

摘要

背景

围手术期睡眠障碍对术后恢复有严重的不利影响。最近,一些观察性研究报告称,穴位刺激(APS)对促进围手术期睡眠质量有益。然而,APS 对全身麻醉后围手术期睡眠障碍的影响尚未被任何系统研究和荟萃分析彻底评估。因此,我们进行了这项系统评价和荟萃分析,以揭示 APS 对围手术期睡眠障碍的影响。

方法

我们彻底搜索了 8 个数据库(中文:中国知网、维普、中国生物医学文献数据库和万方;英文:PubMed、Embase、Web of Science 和 Cochrane Library),以寻找 APS 与围手术期睡眠障碍发生之间存在关联的随机对照试验(RCT)。我们使用 RevMan 5.4(Cochrane 协作组织)和 Stata 16.0(Stata 公司)进行荟萃分析。此外,我们还使用试验序贯分析(TSA)工具来估计数据的有效性和可靠性。

结果

本研究共纳入 9 项 RCT,涉及 719 名患者。与对照组相比,APS 显著改善了围手术期主观睡眠质量(SMD:-1.36;95%CI:-1.71 至-1.01;<0.00001)。此外,APS 还增加了围手术期 TST(术前 MD=24.29,95%CI:6.4 至 42.18, =0.0008;术后 MD=45.86,95%CI:30.00 至 61.71,<0.00001)和 SE(术前 MD=3.62,95%CI:2.84 至 4.39,<0.00001;术后 MD=6.43,95%CI:0.95 至 11.73,<0.00001)。试验序贯分析的结果进一步证实了我们荟萃分析结果的可靠性。

结论

根据现有证据,APS 可有效改善围手术期睡眠质量,在降低围手术期睡眠障碍的发生率方面发挥重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e11e/10783988/12dcac175dfa/IJCLP2024-6763996.001.jpg

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