针刺治疗术后肠梗阻的系统评价再评价＊

目的 评价针刺治疗术后肠梗阻相关系统评价的报告质量、方法学质量和证据等级。方法 计算机检索PubMed、Embase、Cochrane Library、中国知网、万方医学网、维普数据库和SinoMed数据库,搜集公开发表的关于针刺治疗术后肠梗阻的系统评价/Meta分析。采用PRISMA声明评价纳入研究的报告质量,AMSTAR 2量表评价方法学质量,并应用GRADE系统评估证据等级。结果 共纳入7篇系统评价/Meta分析,PRISMA得分均在15.5-26分之间,方案与注册、研究偏倚、其他分析和资金来源等方面存在不足;AMSTAR 2评价提示所有纳入研究的方法学质量偏低;GRADE证据质量分级结果显示,纳入的32个结局指标中共有7个为中等质量,15个为低质量,10个为极低质量。结论 现有证据提示针刺治疗术后肠梗阻疗效肯定,相关系统评价的报告质量良好,方法学与证据质量相对较低,因此在临床实际中应用证据时需谨慎,相关临床试验及系统评价方法学质量有待进一步提高。

Acupuncture Treatment for Postoperative Ileus: An Overview of Systematic Reviews

Objective To evaluate the quality of report, methodology and evidence of the exiting systematic reviews (SRs) of acupuncture treatment for postoperative ileus (POI).Methods PubMed, Embase, the Cochrane Library, CNKI, WanFang Data, VIP and SinoMed database were electronically searched to collect SRs/Meta-analysis of acupuncture therapy. The PRISMA statement was used to evaluate the reporting quality of included studies and AMASTAR 2 tool was used to evaluate the methodological quality. Meanwhile, the GRADE system was used to assess the quality of evidence.Results A total of 7 SRs/Meta-analysis were included. The PRISMA evaluation results showed that the scores of 7 studies ranged from 15.5 to 26. The quality problems of the reports were mainly reflected in the aspects of program and registration, study bias, other analysis and funding sources. The results of AMSTAR 2 evaluation showed that the methodological quality of all included studies was low. The GRADE evaluation results showed that 7 of the 32 outcome indicators included were of medium quality, 15 were of low quality, and 10 were of very low quality.Conclusion The current evidence shows that acupuncture treatment is effective in reducing POI. The quality of the reports was good, but the quality of methodology and evidence was relatively low. Therefore, the application of this evidence in clinical practice should be cautious. The quality of relevant clinical trials and systematic review methodology needs to be further improved.