针刺疗法治疗卒中后便秘的系统评价和Meta分析  

Systematic evaluation and Meta-analysis of acupuncture in the treatment of post-stroke constipation

作　　者：杨秀峰 侯伯松 任雪雁 张延辉 张天生 YANG Xiufeng

机构地区：[1]山西中医药大学,山西太原030024 [2]山西中医药大学第二临床学院,山西太原030024

出　　处：《中医临床研究》2023年第10期99-104,共6页Clinical Journal Of Chinese Medicine

基　　金：山西省医学重点科研项目重大科技攻关专项(2021XM05)。

摘　　要：目的:评估针刺治疗卒中后便秘疗效,为针刺治疗卒中后便秘提供循证医学根据。方法:检索中国生物医学文献检索库、中国知网、万方、维普、PubMed、Cochrane、Embase 2000年1月-2022年3月31日的文献,获取期间所有应用针刺治疗卒中后便秘的随机对照试验。用Endnote 20文献管理软件对检索文献进行筛选和整理,并用Cochrane和RevMan 5.4软件对其进行质量评价和结果分析。结果:共纳入文献11篇,涉及813例受试者。试验组总体临床愈显率优于对照组[OR=3.21,95%CI(2.16,4.79),P<0.00001]。其中针刺疗法试验组的疗效优于口服麻仁润肠丸对照组[OR=3.04,95%CI(1.48,6.24),P=0.002];单纯针刺试验组的疗效优于口服乳果糖溶液对照组[OR=3.82,95%CI(1.91,7.64),P=0.0002];临床便秘症状积分[MD=-1.45,95%CI(-1.74,-1.16),P<0.00001];排便间隔时间[MD=-42.22,95%CI(-48.05,-36.39),P<0.00001]。另有4篇文献记录了轻度不良反应,无脱落现象。结论:针刺疗法可有效改善卒中后便秘症状,且安全性较高。由于选取文献数量、质量限制,未来仍旧需要更多长期随访的高质量研究报告来补充验证以上结论。Objective:To evaluate the effect of acupuncture on constipation after stroke and provide evidence-based foundation.Methods:The literature in Chinese biomedical literature search database,CNKI,Wanfang,VIP,PubMed,Cochrane and Embase was searched from January 2000 to March 31,2022.Endnote 20 document management software was used to screen and sort out the retrieved documents.Cochrane and RevMan 5.4 software was used to evaluate the quality and analyze the results.Results:A total of 11 articles and 813 subjects were included.The clinical recovery rate in the test group was better than the control group[OR=3.21,95%CI(2.16,4.79),P<0.00001].Among them,the curative effect in acupuncture therapy test group was better than oral Maren Runchang Wan(麻仁润肠丸)control group[OR=3.04,95%CI(1.48,6.24),P=0.002],and the curative effect in the simple acupuncture test group was better than the oral lactulose solution control group[OR=3.82,95%CI(1.91,7.64),P=0.0002].Clinical constipation symptom score[MD=-1.45,95%CI(-1.74,-1.16),P<0.00001].Defecation interval[MD=-42.22,95%CI(-48.05,-36.39),P<0.00001].Conclusion:Acupuncture therapy has definite curative effects and high safety in relieving constipation symptoms of post-stroke patients.In the future,more high-quality RCT articles with long-term follow-up are needed to confirm the above conclusion.

关 键 词：针刺疗法 卒中后便秘 系统性评价 META分析 随机对照试验 

分 类 号：R255.2[医药卫生—中医内科学]