经皮穴位电刺激对老年膝关节置换病人术后疼痛及功能影响的Meta分析  

Effect of transcutaneous electrical acupoint stimulation on pain and functional outcome in elderly patients with knee arthroplasty:a Meta-analysis

作　　者：苏晚英 王恒旭 齐琼 秦梅兰[1] 杨超[1] 秦月兰[1] SU Wanying;WANG Hengxu;QI Qiong;QIN Meilan;YANG Chao;QIN Yuelan(Hunan Provincial People′s Hospital(The First Affiliated Hospital of Hunan Normal University),Hunan 410005 China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院),湖南410005

出　　处：《循证护理》2023年第15期2692-2701,共10页Chinese Evidence-Based Nursing

基　　金：湖南省卫生健康委科研计划项目,编号:202114021174,202214022670。

摘　　要：目的:系统评价经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)对老年膝关节置换病人术后疼痛及功能的影响。方法:计算机检索万方数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、PubMed、Web of Science、Cochrane Central Register of Controlled Trials(Central)、EMbase等数据库关于TEAS用于膝关节置换手术的随机对照研究,检索时限为建库至2022年8月。由2名研究人员独立完成文献筛选、数据提取及质量评价,并采用RevMan 5.3进行Meta分析。结果:纳入15篇文献,涉及979例病人,其中TEAS组488例,对照组491例。Meta分析结果显示:TEAS组术后6 h、24 h、48 h、72 h、5 d以及7 d的疼痛视觉模拟评分(VAS)得分较对照组降低(P<0.05),术后7 d膝关节功能评分高于对照组(P<0.05),术后14 d的膝关节功能评分两组差异无统计学意义(P>0.05)。TEAS组术后1、2、3、7 d的膝关节活动度均优于对照组(P<0.05),术后恶心呕吐及头晕头痛发生率明显降低(P<0.05),两组术后皮肤瘙痒发生率比较,差异无统计学意义(P>0.05)。结论:现有证据表明,TEAS可缓解老年病人膝关节置换术后疼痛、促进膝关节功能早期恢复,降低术后不良反应发生率。Objective:To systematically evaluate the effects of transcutaneous electrical acupoint stimulation(TEAS)on pain and function in elderly patients with knee arthroplasty knee arthroplasty.Methods:The randomized controlled study on TEAS for knee replacement surgery were retrieved from WanFang database,CNKI,CBM,VIP,PubMed,Web of Science,Cochrane Central Register of Controlled Trials(Central),EMbase.The retrieval time was from the inception to August 2022.Two researchers independently completed literature screening,data extraction and quality assessment,and Meta-analysis was performed using RevMan 5.3 software.Results:Atotal of 15 articles including 979 patients satisfied the inclusion criteria,and 488 patients in TEAS group and 491 patients in control group.Meta-analysis results showed that:the VAS pain scores were significantly decreased in the TEAS group at 6 h,24 h,48 h,72 h,5 d and 7 d after surgery(P<0.05),and the knee function scores after surgery at 7 d were higher than those in the control group(P<0.05).There was no significant difference in the knee function scores after surgery at 14 d between the two groups.The range of motion of the knee in TEAS group was significantly better than that in control group at 1,2,3 and 7 days after operation(P<0.05),and the incidence of postoperative nausea,vomiting,dizziness and headache was significantly lower(P<0.05).There was no significant difference in the incidence of postoperative skin pruritus between the two groups(P>0.05).Conclusion:Current evidence shows that TEAS can relieve pain in elderly patients with knee arthroplasty,promote the early recovery of knee function,and reduce the incidence of postoperative adverse reactions.

关 键 词：经皮穴位电刺激 膝关节置换 疼痛 META分析 循证护理 

分 类 号：R473.6[医药卫生—护理学]