The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong, Guangzhou 510405, China.
The fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangdong, Shenzhen 518033, China.
Complement Ther Med. 2024 Dec;87:103105. doi: 10.1016/j.ctim.2024.103105. Epub 2024 Oct 28.
Mechanical ventilation after respiratory insufficiency can induce diaphragm dysfunction through various hypothesized mechanisms. In this study, we evaluated the rehabilitative effect of acupuncture on diaphragm function in patients with respiratory insufficiency using meta-analysis and summarised the rules of acupoints through association rules analysis.
Articles (published from January 2000 to February 2024) were retrieved from the following databases: PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP, SinoMed, and Wanfang. Two researchers conducted literature selection, data extraction, and statistical analysis independently. The risk of bias was assessed utilizing the Physical Therapy Evidence Database (PEDro) scale. The meta-analysis was performed with RevMan 5.4 software, and the quality of each outcome evidence was assessed via the online software GRADEpro GDT. The regularity of acupoint selection was summarized using association rules analysis. This study is registered on PROSPERO, number CRD42024526705.
Eleven articles were eventually included, all of which were of low to moderate quality. Results of the meta-analysis showed a significant increase in diaphragmatic thickening fraction (MD 3.40 [1.52, 5.27]) and diaphragmatic excursion (MD 0.95 [0.58, 1.31]) in patients with respiratory insufficiency after acupuncture treatment. Also, OI (MD 28.52 [15.93, 41.11]) and PaO (MD 7.18 [2.22, 12.13]) were significantly elevated and PaCO (MD -6.94 [-12.30, -1.59]) was decreased. Mechanical ventilation time (MD-1.86 [-2.28, -1.45]) was also significantly improved. The overall quality of the outcome evidence is deemed moderate. Association rules analysis showed that ST36, RN4, RN6, and others are core acupoints for the treatment of diaphragmatic dysfunction in patients with respiratory insufficiency by acupuncture.
Acupuncture shows potential in the rehabilitation of patients with respiratory insufficiency and may serve as a complementary and alternative therapy for related conditions. We suggest the use of ST36 as a core acupoint, in combination with other acupoints. Due to the potential publication bias and high heterogeneity of the current data, further high-quality RCTs are needed to confirm these findings.
呼吸功能不全后的机械通气可能通过各种假设的机制引起膈肌功能障碍。在这项研究中，我们通过荟萃分析评估了针刺对呼吸功能不全患者膈肌功能的康复效果，并通过关联规则分析总结了穴位规律。
从以下数据库中检索（2000 年 1 月至 2024 年 2 月）发表的文章：PubMed、Cochrane 图书馆、Embase、Web of Science、CNKI、VIP、SinoMed 和万方。两名研究人员独立进行文献选择、数据提取和统计分析。使用物理治疗证据数据库（PEDro）量表评估偏倚风险。使用 RevMan 5.4 软件进行荟萃分析，使用在线软件 GRADEpro GDT 评估每个结局证据的质量。使用关联规则分析总结穴位选择的规律。本研究在 PROSPERO 上注册，编号为 CRD42024526705。
最终纳入 11 篇文章，均为低至中等质量。荟萃分析结果显示，呼吸功能不全患者针刺治疗后膈肌增厚率（MD 3.40[1.52，5.27]）和膈肌移动度（MD 0.95[0.58，1.31]）显著增加。同时，OI（MD 28.52[15.93，41.11]）和 PaO（MD 7.18[2.22，12.13]）显著升高，PaCO（MD-6.94[-12.30，-1.59]）降低。机械通气时间（MD-1.86[-2.28，-1.45]）也显著改善。结局证据的总体质量被认为是中等的。关联规则分析显示，ST36、RN4、RN6 等是针刺治疗呼吸功能不全患者膈肌功能障碍的核心穴位。
针刺在呼吸功能不全患者的康复中显示出潜力，可能成为相关疾病的一种补充和替代治疗方法。我们建议使用 ST36 作为核心穴位，结合其他穴位。由于当前数据存在潜在的发表偏倚和高度异质性，需要进一步进行高质量的 RCT 来证实这些发现。
