Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Office of National Clinical Research Base of TCM, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
JMIR Res Protoc. 2024 Aug 29;13:e55996. doi: 10.2196/55996.
Perioperative neurocognitive disorder (PND) is a critical concern for older patients undergoing cardiac surgery, impacting cognitive function and quality of life. Electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS) hold promise for mitigating PND. This protocol outlines a systematic review and meta-analysis to thoroughly assess the efficacy of electroacupuncture and TEAS in older patients undergoing cardiac surgery with PND, providing up-to-date evidence for PND prevention and treatment.
This study aimed to thoroughly assess the efficacy of electroacupuncture and TEAS in older patients undergoing cardiac surgery with PND, providing up-to-date evidence for PND prevention and treatment.
A comprehensive and systematic approach will be used to identify eligible studies from a diverse range of electronic databases, including 9 major sources such as PubMed (NLM) and Cochrane (Wiley), as well as 2 clinical trial registration websites. These studies will focus on investigating the effects of electroacupuncture and TEAS on PND in older patients undergoing cardiac surgery. The study selection will adhere to the criteria outlined in the patient, intervention, comparison, outcome, and studies (PICOS) format. Data extraction will be carried out by 2 independent researchers (YP and LS), using established tools to evaluate the risk of bias. The primary outcome will be PND incidence, with secondary outcomes including Mini Mental State Examination scores, neuron-specific enolase, S100β, interleukin-1β, interleukin-6, tumor necrosis factor-α, time to first flatus, first defecation, bowel sound recovery, and hospitalization duration to be selectively reported. Adverse events linked to acupuncture, such as bleeding, needle site pain, and local reactions, rather than serious adverse events, will also be considered. Meta-analysis will be performed using appropriate statistical methods to assess the overall effect of electroacupuncture and TEAS on PND prevention, treatment, or other relevant outcomes. The Cochrane Collaboration Risk of Bias tool will be used for assessment, and data synthesis will be executed using the RevMan 5.4 software (Cochrane).
We plan to summarize the eligible studies through the use of a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. The findings will be showcased in the form of a summary table of evidence. Figures and forest plots will be used to illustrate the outcomes of the meta-analysis.
The impacts of electroacupuncture and TEAS interventions on PND in older patients undergoing cardiac surgery have not yet been established. This protocol addresses a critical gap by thoroughly assessing electroacupuncture and TEAS for PND in older patients undergoing cardiac surgery, enhancing understanding of nonpharmacological interventions, and guiding future research and clinical practices in this field. Its strength lies in rigorous methodology, including comprehensive search strategies, independent review processes, and thorough assessments of the risk of bias.
PROSPERO CRD42023411927; https://tinyurl.com/39xdz6jb.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/55996.
围术期神经认知障碍（PND）是老年心脏手术患者的一个关键问题，会影响认知功能和生活质量。电针和经皮穴位电刺激（TEAS）有望减轻 PND。本方案旨在系统地评估电针和 TEAS 对老年心脏手术合并 PND 患者的疗效，为 PND 的预防和治疗提供最新证据。
本研究旨在全面评估电针和 TEAS 对老年心脏手术合并 PND 患者的疗效，为 PND 的预防和治疗提供最新证据。
我们将采用全面而系统的方法，从多种电子数据库中筛选合格的研究，包括 9 个主要来源，如 PubMed（NLM）和 Cochrane（Wiley），以及 2 个临床试验注册网站。这些研究将集中探讨电针和 TEAS 对老年心脏手术合并 PND 患者的影响。研究选择将遵循患者、干预、比较、结局和研究（PICOS）格式的标准。两名独立的研究人员（YP 和 LS）将使用既定工具提取数据，以评估偏倚风险。主要结局为 PND 发生率，次要结局包括简易精神状态检查评分、神经元特异性烯醇化酶、S100β、白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α、首次排气时间、首次排便时间、肠鸣音恢复时间和住院时间等，将选择性报告。还将考虑与针刺相关的不良事件，如出血、针位点疼痛和局部反应，而不是严重不良事件。Meta 分析将使用适当的统计方法评估电针和 TEAS 对 PND 预防、治疗或其他相关结局的总体效果。我们将使用 Cochrane 协作风险偏倚工具进行评估，并使用 RevMan 5.4 软件（Cochrane）进行数据综合。
我们计划通过使用 PRISMA（系统评价和荟萃分析的首选报告项目）流程图来总结合格的研究。研究结果将以证据总结表的形式呈现。图表和森林图将用于说明荟萃分析的结果。
电针和 TEAS 干预对老年心脏手术合并 PND 患者的影响尚未确定。本方案通过全面评估电针和 TEAS 对老年心脏手术合并 PND 患者的作用，解决了这一关键空白，增进了对非药物干预的理解，并为该领域的未来研究和临床实践提供了指导。其优势在于严格的方法学，包括全面的搜索策略、独立的审查过程以及对偏倚风险的全面评估。
PROSPERO CRD42023411927；https://tinyurl.com/39xdz6jb。
国际注册报告标识符（IRRID）：PRR1-10.2196/55996。
