经皮穴位电刺激对肺叶切除术后辅助镇痛效果的meta分析  

Meta-analysis of the effect of transcutaneous electrical acupoint stimulation on adjuvant analgesia after lobectomy

作　　者：周代勇 倪广生 张怡 明润宇 徐朝军[1] ZHOU Daiyong;NI Guangsheng;ZHANG Yi;MING Runyu;XU Zhaojun(The First Hospital Affiliated to Hunan University of Chinese Medicine,Hunan,Changsha 410007,China;Hunan University of Chinese Medicine,Hunan,Changsha 410208,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]湖南中医药大学,湖南长沙410208

出　　处：《中国医药科学》2023年第23期186-190,共5页China Medicine And Pharmacy

基　　金：湖南省教育厅科学研究项目(22A0243)。

摘　　要：目的系统评价经皮穴位电刺激(TEAS)对肺叶切除术后辅助镇痛的效果。方法由2名评价员检索PubMed、Cochrane Library、Web of Science、Embase、CNKI、Wanfang、VIP和Chinese Biomedical Database,检索时限为建库至2023年3月23日。收集有关TEAS用于肺叶切除术后辅助镇痛的随机对照试验。采用RevMan 5.3软件进行meta分析。结果共纳入5篇文献,共计383例患者。meta分析显示,试验组术后2、6、12、24、48 h视觉模拟疼痛评分[术后2 h,MD=-0.81,95%CI(-0.97,-0.64),P<0.00001;术后6 h,MD=-1.11,95%CI(-1.48,-0.74),P<0.00001;术后12 h,MD=-1.01,95%CI(-1.29,-0.74),P<0.00001;术后24 h,MD=-0.92,95%CI(-1.06,-0.77),P<0.00001;术后48 h,MD=-0.77,95%CI(-1.14,-0.40),P<0.0001]明显低于对照组;试验组在术后48 h内自控静脉镇痛(PICA)按压次数[MD=-2.86,95%CI(-6.07,0.34),P=0.08]与对照组差异无统计学意义;与对照组相比,试验组在术后舒芬太尼使用剂量[MD=-29.00,95%CI(-44.72,-13.28),P=0.0003]、术后恶心呕吐(PONV)的发生率[OR=0.14,95%CI(0.04,0.54),P=0.004]显著降低。结论TEAS可显著提高肺叶切除术后镇痛的效果,减少术后镇痛药物的使用,并降低术后PONV的发生率。Objective To systematically evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)for analgesia after lobectomy.Methods Two evaluators searched PubMed,Cochrane Library,Web of Science,Embase,CNKI,Wanfang,VIP and Chinese Biomedical Database.The retrieval time was from the establishment of the database to March 23,2023.Randomized controlled trials on applying TEAS for adjuvant analgesia after lobectomy were collected.Meta-analysis was performed using RevMan 5.3 software.Results A total of 5 literatures were included,with a total of 383 patients.Meta-analysis showed that visual analogue scale scores of the experimental group at 2,6,12,24 and 48 hours after surgery(2 hours after surgery,MD=-0.81,95%CI[-0.97,-0.64],P<0.00001;6 hours after surgery,MD=-1.11,95%CI[-1.48,-0.74],P<0.00001;12 hours after surgery,MD=-1.01,95%CI[-1.29,-0.74],P<0.00001;24 hours after surgery,MD=-0.92,95%CI[-1.06,-0.77],P<0.00001;48 hours after surgery,MD=-0.77,95%CI[-1.14,-0.40],P<0.0001)was significantly lower than that of the control group.There was no difference between the experimental group and the control group in the number of patient controlled intravenous analgesia(PICA)compressions(MD=-2.86,95%CI[-6.07,0.34],P=0.08)within 48 hours after surgery.Compared with the control group,the dosage of sufentanil(MD=-29.00,95%CI[-44.72,-13.28],P=0.0003)and the incidence of postoperative nausea and vomiting(PONV)(OR=0.14,95%CI[0.04,0.54],P=0.004)in experimental group were significantly decreased.Conclusion TEAS can significantly improve the analgesic effect after lobectomy,reduce the use of postoperative analgesic drugs,and reduce the incidence of PONV.

关 键 词：经皮穴位电刺激 肺叶切除 术后辅助镇痛 术后恶心呕吐 META分析 

分 类 号：R614[医药卫生—麻醉学]