耳穴压豆对肛肠病术后镇痛疗效的Meta分析

目的 系统评价耳穴压豆对肛肠病术后镇痛的临床疗效。方法 计算机检索中国知识资源总库(CNKI)、中文科技期刊数据库(VIP)、中国学术期刊数据库(WanFangData)、中国生物医学文献数据库(CBM)、PubMed、Embase、CochraneLibrary、ClinicalTrial中耳穴压豆应用于肛肠病术后镇痛的临床随机对照试验(RCT),检索时间范围为建库至2021年8月,参照Cochrane质量评价标准评价文献质量,应用RevMan5.3软件进行Meta分析。结果 最终纳入11篇RCT文献,涉及患者1158例。Meta分析结果显示,与对照组相比,试验组能降低术后6h(MD=-1.84,95%CI-2.65,-1.04],Z=4.50,P<0.000 01)、24 h(MD=-0.85,95%CI-1.25,-0.46],Z=4.22,P<0.000 1)、48 h(MD=-1.22,95%CI-1.86,-0.58],Z=3.73,P<0.05)、72h(MD=-1.16,95%CI-1.64,-0.67],Z=4.64,P<0.05)的VAS评分,镇痛有效率高于对照组(OR=8.70,95%CI1.89,40.10],Z=2.78,P<0.05),不良反应发生率低于对照组(OR=0.15,95%CI0.05,0.43],Z=3.56,P<0.05)。术后7d的VAS评分2组比较差异无统计学意义(P>0.05)。结论 耳穴压豆能够有效减轻肛肠病患者术后疼痛,不良反应发生率低,但是仍需要进一步大规模、高质量、多中心的RCT验证。

Meta-analysis on the Efficacy of Auricular Point Sticking for Postoperative Analgesia in Anorectal Disease

Objective To systematically evaluate the clinical efficacy of auricular acupoint sticking for postoperative analgesia of anorectal disease. Methods RCTs of auricular acupoint sticking for postoperative analgesia of anorectal disease were retrieved from CNKI, VIP, WanFang Data, CBM, PubMed, Embase,Cochrane Library, and Clinical Trial. The retrieval time was from the establishment of the databases to August,2021. The quality of literature was evaluated with reference to Cochrane quality evaluation standards. Metaanalysis was performed using RevMan 5.3. Results A total of 11 RCTs were included, involving 1 158 patients.The results of Meta-analysis showed that compared with the control group, the treatment group could reduce VAS score of 6 h(MD =-1.84, 95% CI -2.65,-1.04], Z = 4.50, P<0.000 01) and 24 h(MD =-0.85, 95% CI -1.25,-0.46], Z = 4.22, P<0.000 1), 48 h(MD=-1.22, 95% CI -1.86,-0.58], Z = 3.73, P<0.05), 72 h(MD =-1.16, 95% CI -1.64,-0.67], Z = 4.64, P<0.05) after operation, the effective rate of the treatment group was significantly higher than that of the control group(OR = 8.70, 95% CI 1.89, 40.10], Z = 2.78, P<0.05), and the incidence of adverse reactions was lower than that of the control group(OR = 0.15, 95% CI 0.05, 0.43], Z =3.56, P<0.05). There was no significant difference in the VAS score of the two groups at 7 days after operation(P>0.05). Conclusion Auricular acupoint sticking can effectively reduce the postoperative pain of patients with anorectal disease, and the incidence of adverse reactions is low. However, further large-scale, high-quality,multi-center RCTs are still needed for verification.