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针灸可减少结肠镜检查患者的镇静剂和麻醉剂用量并提高疼痛耐受性:一项Meta分析。

Acupuncture reduces sedative and anaesthetic consumption and improves pain tolerance in patients undergoing colonoscopy: a Meta-analysis.

作者信息

Bingyu Wang, Fangfang Jin, Jiawei Gao, Liuxin Yang, Yali Zhang, Xingxing Yuan, Yang Zhang

机构信息

School of Graduate Studies, Heilongjiang University of Chinese Medicine, Harbin 150040, China.

2 Department of Gastroenterology, Heilongjiang Academy of Traditional Chinese Medicine, Harbin 150006, China.

出版信息

J Tradit Chin Med. 2024 Dec;44(6):1091-1103. doi: 10.19852/j.cnki.jtcm.20240926.001.

Abstract

OBJECTIVE

To evaluate the effects of acupuncture anesthesia on the consumption of sedatives and anesthetics, pain, and time consumption in patients undergoing colonoscopy, thus providing evidence that acupuncture anesthesia should be extended to endoscopists and anesthetists.

METHODS

Four English and four Chinese databases were searched for randomised controlled trials of acupuncture anaesthesia in patients undergoing colonoscopy, published from database inception to 1 March 2023. Outcomes were consumption of sedatives and anaesthetics, pain tolerance, visual analog scale (VAS) score, the meantime consumption of examination, satisfaction, and adverse reactions.

RESULTS

Thirty-one randomized controlled trials with a total of 4790 participants were included. Results showed that acupuncture anaesthesia significantly reduced consumption of sedatives and anaesthetics [9 studies, = 944, standardized mean difference () = -0.82, 95% (-1.31, -0.33), 0.001], VAS score [9 studies, = 1790, mean difference () = -1.13, 95% (-1.70, -0.57), < 0.001], meantime consumption [21 studies, = 3799, = -2.09, 95% (-3.15, -1.03)<0.001] and adverse reactions of colonoscopy [7 studies, = 738, odds ratio () = 0.17, 95% (0.10, 0.28), <0.001]. Acupuncture also significantly improved pain tolerance [14 studies, 1661, = 7.05, 95% (3.79, 13.12), <0.001], while no beneficial effects were found for satisfaction [7 studies, 843, 0.02, 95% (-0.38, 0.43), = 0.91].

CONCLUSION

Acupuncture has beneficial effects on patients undergoing colonoscopy, particularly in reducing consumption of sedatives and anaesthetics, alleviating pain, shortening the time consumption of examination and preventing adverse events. As an alternative, effective, inexpensive, and accessible approach, acupuncture anaesthesia should be extended to endoscopists and anaesthesiologists.

摘要

目的

评估针刺麻醉对结肠镜检查患者镇静剂和麻醉剂用量、疼痛及检查耗时的影响,从而为针刺麻醉应推广至内镜医师和麻醉医师提供证据。

方法

检索四个英文数据库和四个中文数据库,查找从建库至2023年3月1日发表的关于针刺麻醉用于结肠镜检查患者的随机对照试验。结局指标为镇静剂和麻醉剂用量、疼痛耐受性、视觉模拟量表(VAS)评分、检查平均耗时、满意度及不良反应。

结果

纳入31项随机对照试验,共4790名参与者。结果显示,针刺麻醉显著减少了镇静剂和麻醉剂用量[9项研究,n = 944,标准化均差(SMD)=-0.82,95%CI(-1.31,-0.33),P < 0.001]、VAS评分[9项研究,n = 1790,平均差(MD)=-1.13,95%CI(-1.70,-0.57),P < 0.001]、检查平均耗时[21项研究,n = 3799,MD =-2.09,95%CI(-3.15,-1.03),P < 0.001]以及结肠镜检查的不良反应[7项研究,n = 738,比值比(OR)= 0.17,95%CI(0.10,0.28),P < 0.001]。针刺还显著提高了疼痛耐受性[14项研究,n = 1661,MD = 7.05,95%CI(3.79,13.12),P < 0.001],而在满意度方面未发现有益影响[7项研究,n = 843,MD = 0.02,95%CI(-0.38,0.43),P = 0.91]。

结论

针刺对接受结肠镜检查患者有益,尤其在减少镇静剂和麻醉剂用量、减轻疼痛、缩短检查耗时及预防不良事件方面。作为一种替代、有效、廉价且可及的方法,针刺麻醉应推广至内镜医师和麻醉医师。

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本文引用的文献

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Acupuncture, from the ancient to the current.针灸,从古至今。
Anat Rec (Hoboken). 2021 Nov;304(11):2365-2371. doi: 10.1002/ar.24625. Epub 2021 Apr 6.

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