针刺治疗术后肠梗阻的系统评价再评价  

Acupuncture Treatment for Postoperative Ileus: An Overview of Systematic Reviews

作　　者：叶子 魏绪强 冯寿全[1] 顾群浩[1] 李璟[1] 冯晨晨 裴丽娟 王珂 周嘉 Ye Zi;Wei Xuqiang;Feng Shouquan;Gu Qunhao;Li Jing;Feng Chenchen;Pei Lijuan;Wang Ke;Zhou Jia(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Graduate School,Shanghai University of Traditional Chinese Medicin,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学研究生院,上海201203

出　　处：《世界科学技术-中医药现代化》2022年第2期867-877,共11页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家中医药管理局中医药循证能力建设项目(2019XZZX-ZJ0011):针灸治疗优势病的循证研究,负责人:周嘉;上海市卫生健康委员会标准预研制项目(2020WB23):针刺全程干预促进胃肠手术术后早期胃肠功能恢复应用标准规范,负责人:周嘉;上海市卫生和计划生育委员会科研课题(201840011):围术期电针在肿瘤腹部手术加速术后康复的临床应用及研究,负责人:周嘉。

摘　　要：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。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 7studies 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.

关 键 词：针刺疗法 术后肠梗阻 系统评价 META分析 系统评价再评价 

分 类 号：R245[医药卫生—针灸推拿学]