耳穴贴压对胃癌病人术后胃肠功能恢复影响的Meta分析

目的:系统评价耳穴贴压对胃癌病人术后胃肠功能恢复的干预效果。方法:计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(WanFang Data)、中文科技期刊数据库(VIP)、PubMed、EMbase、Web of Science、CINAHL(EBSCO Host)和Cochrane临床对照实验中心注册数据库(Cochrane Central Register of Controlled Trials,CENTRAL)中关于耳穴贴压对胃癌病人术后胃肠功能恢复的随机对照试验及半随机对照试验。检索时间为建库至2020年5月31日。依据文献纳入及排除标准进行筛查、提取资料,利用Cochrane手册5.1.0推荐的随机对照试验偏倚风险评估工具评价文献质量,采用RevMan 5.2软件进行Meta分析。结果:最终纳入12项研究,包括1370例研究对象。Meta分析结果显示,术前对干预组病人采用耳穴贴压,肛门首次排气时间短于对照组接受常规护理的病人MD=-34.52,95%CI(-48.24,-20.81),P<0.00001],术后干预组肛门首次排气时间短于对照组病人MD=-11.92,95%CI(-14.39,-9.44),P<0.00001],术前干预组首次排便时间短于对照组病人MD=-34.98,95%CI(-47.69,-22.26),P<0.00001],术后干预组首次排便时间短于对照组病人MD=-10.62,95%CI(-15.86,-5.37),P<0.0001],术后干预组肠鸣音恢复时间短于对照组病人MD=-7.58,95%CI(-10.25,-4.92),P<0.00001],术后干预组腹胀消失时间短于对照组病人MD=-3.46,95%CI(-4.76,-2.16),P<0.00001]。结论:现有证据表明,耳穴贴压能够有效改善胃癌病人术后的胃肠功能情况。由于本研究评价指标间存在异质性,因此,需要更多临床多中心、大样本、高质量的研究进一步评价耳穴贴压对胃癌术后病人胃肠功能恢复的综合效果。

Effect of auricular acupressure therapy on postoperative gastrointestinal function rehabilitation in patients with gastric cancer:a Meta-analysis

Objective:To systematically evaluate the intervention effect of auricular acupressure therapy on postoperative gastrointestinal function rehabilitation in patients with gastric cancer.Methods:Randomized and semi-randomized controlled trials of auricular acupressure therapy on postoperative gastrointestinal function in patients with gastric cancer,were retrieved from CNKI,CBM,WanFang Data,VIP,PubMed,EMbase,Web of Science,CINAHL(EBSCO Host)and Cochrane Central Registry of Controlled Trials.The retrieval time was from inception to May 31,2020.The data were screened and extracted according to the inclusion and exclusion criteria.The quality of the literature was evaluated by using the risk assessment tool of RCT recommended by Cochrane Handbook 5.1.0.Revman 5.2 software was used for Meta-analysis.Results:Finally,12 studies were included,involving 1370 subjects.Meta-analysis results showed that:patients in the intervention group were treated with auricular point sticking preoperatively,and the first anal exhaust time was shorter than that in the control group who received conventional careMD=-34.52,95%CI(-48.24,-20.81),P<0.00001].The first anal exhaust time of the intervention group was shorter than that in the control groupMD=-11.92,95%CI(-14.39,-9.44),P<0.00001],the first defecation time of the intervention group was shorter than that in the control groupMD=-34.98,95%CI(-47.69,-22.26),P<0.00001],and the first defecation time of the intervention group was shorter than that in the control groupMD=-10.62,95%CI(-15.86,-5.37),P<0.0001].The recovery time of intestinal sounds in the intervention group was shorter than that in the control groupMD=-7.58,95%CI(-10.25,-4.92),P<0.00001],and the disappearance time of abdominal distension in the intervention group was shorter than that in the control groupMD=-3.46,95%CI(-4.76,-2.16),P<0.00001].Conclusion:Current evidences shows that auricular acupressure therapy can effectively improve postoperative gastrointestinal function of gastric cancer.Due to the heterogeneity of the evaluation indexes in this study,more clinical multi-center,large sample and high-quality studies are needed to further evaluate the comprehensive effect of auricular acupressure therapy on postoperative gastrointestinal function rehabilitation of gastric cancer.