针灸治疗脊髓损伤后神经源性肠道功能障碍的Meta分析  

Acupuncture for Neurogenic Intestinal Dysfunction after Spinal Cord Injury:A Meta-analysis

作　　者：欧阳建[1] 杨淇 倪力力 陆小龙 OUYANG Jian;YANG Qi;NI Lili;LU Xiaolong(Hunan University of Traditional Chinese Medicine,Changsha 410000,China;不详)

机构地区：[1]湖南中医药大学,湖南长沙410000 [2]湖南中医药大学第二附属医院

出　　处：《中国医学创新》2022年第16期174-179,共6页Medical Innovation of China

基　　金：2021年度湖南省中医药科研计划项目(2021030)。

摘　　要：目的:系统评价针灸治疗脊髓损伤后神经源性肠道功能障碍的有效性。方法:电子检索2010年后在中国知网(CNKI)、万方医学数据库、中文科技期刊数据库和中国生物医学文献数据库(CBM)、维普数据库、Cochrane Library、PubMed、Embase等发表的针灸治疗脊髓损伤后神经源性肠道功能障碍患者的临床随机对照试验。由两名研究人员依据纳入标准与排除标准进行文献筛选、提取数据,采用Rev Man 5.3软件对结局指标进行Meta分析。结果:最终纳入14篇文献,共838例患者。Meta分析结果显示,普通针刺的疗效优于其他治疗方法,两组患者有效率比较,差异有统计学意义[RR=1.88,95%CI(1.06,3.32),Z=2.17,P=0.03];灸法的疗效优于其他治疗方法,两组患者有效率比较,差异有统计学意义[RR=1.24,95%CI(1.11,1.39),Z=3.81,P=0.000 1]。经针灸治疗,两组患者在神经源性肠功能障碍评分[MD=-3.28,95%CI(-4.25,-2.30),Z=6.60,P<0.000 01]、FIM总则评分[MD=1.37,95%CI(0.41,2.33),Z=2.80,P=0.005]、排便障碍评分[MD=-5.17,95%CI(-8.13,-2.21),Z=3.42,P=0.000 6]、肠内钡条总数[MD=-4.18,95%CI(-6.77,-1.59),Z=3.17,P=0.002]上具有显著差异。结论:针灸治疗脊髓损伤后神经源性肠道功能障碍有效,且联合常规治疗后效果更为显著,值得临床推广应用。Objective:To systematically evaluate the efficacy of acupuncture in the treatment of neurogenic intestinal dysfunction after spinal cord injury.Method:The clinical randomized controlled trial of patients with neurogenic intestinal dysfunction after spinal cord injury treated with acupuncture published in CNKI,Wanfang,China Science and Technology Journal Database,CBM,VIP Data,Cochrane Library,PubMed and Embase after 2010 were retrieved electronically.The data were extracted by two researchers according to the inclusion and exclusion criteria,the results were analyzed by RevMan 5.3 software in a Meta-analysis.Result:A total of 838patients were included in 14 articles.The results of Meta-analysis showed that the curative effect of general acupuncture was better than that of other methods,the difference between the two groups was statistically significant [RR=1.88,95%CI(1.06,3.32),Z=2.17,P=0.03].The curative effect of moxibustion was better than that of other methods,the difference between the two groups was statistically significant [RR=1.24,95%CI(1.11,1.39),Z=3.81,P=0.000 1].After acupuncture treatment,there were significant differences in the scores of neurogenic intestinal dysfunction [MD=-3.28,95%CI(-4.25,-2.30),Z=6.60,P<0.000 01],FIM score [MD=1.37,95%CI(0.41,2.33),Z=2.80,P=0.005],defecation disorder score [MD=-5.17,95%CI(-8.13,-2.21),Z=3.42,P=0.000 6] and total number of intestinal barium strips [MD=-4.18,95%CI(-6.77,-1.59),Z=3.17,P=0.002] between two groups.Conclusion:Acupuncture is effective in the treatment of neurogenic intestinal dysfunction after spinal cord injury,and combined with routine treatment is more effective,it is worthy of clinical application.

关 键 词：针灸 脊髓损伤 神经源性肠道功能障碍 META分析 

分 类 号：R246[医药卫生—针灸推拿学]