腕踝针干预术后疼痛疗效的Meta分析和Grade评价  

Efficacy of Wrist-ankle Acupuncture Intervention in Postoperative Pain:A Meta-analysis and Grade Evaluation

作　　者：于明珠 赵丹娜 杨艾影 喻悦 李鑫滟 朱宇 YU Mingzhu;ZHAO Danna;YANG Aiying;YU Yue;LI Xinyan;ZHU Yu(School of Nursing,Anhui University of Chinese Medicine,Hefei 230012,Anhui Province,China;Department of Nursing,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,Anhui Province,China)

机构地区：[1]安徽中医药大学护理学院,安徽合肥230012 [2]安徽中医药大学第一附属医院护理部,安徽合肥230031

出　　处：《军事护理》2024年第5期101-106,114,共7页MILITARY NURSING

基　　金：安徽省高校科学研究项目社科重点(2022AH050423)。

摘　　要：目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随机对照试验,检索时限为建库至2023年10月。采用RevMan 5.4软件进行Meta分析。结果纳入23篇文献,共计1968例患者,Meta分析结果显示,与常规治疗相比,腕踝针能够提高术后疼痛患者的总有效率[OR=4.42,95%CI(2.60,7.50),P<0.001],术后镇痛泵药量使用减少[MD=-9.03,95%CI(-12.09,-5.98),P<0.001],术后疼痛评分降低[MD=-1.39,95%CI(-1.68,-1.09),P<0.001],可减少不良反应发生率[RR=0.40,95%CI(0.32,0.48),P<0.001]以及临床满意度[OR=3.94,95%CI(2.40,6.48),P<0.001]。Grade证据分级结果显示:总有效率、不良反应发生率和临床满意度3项结局指标为中等质量证据,VAS评分指标为低质量证据,镇痛泵药量使用指标为极低质量证据。结论腕踝针可提高总有效率,减少术后镇痛药用量,不良反应少,安全性高,为患者提供了一种安全有效的镇痛方式。Objective To evaluate systematically the efficacy and safety of wrist-ankle acupuncture therapy for postoperative pain with the Grade approach and the method of evidence-based medicine.Methods CNKI,Wanfang,VIP,CBM,PubMed,Embase,Web of Science and Cochrane Library were searched for the randomized controlled trials of the wrist-ankle acupuncture intervention in postoperative pain from inception to Oct 2023.RevMan 5.4 software was used for Meta-analysis.Results 23 articles were included,covering 1968 patients.The results of meta-analysis showed that wrist-ankle acupuncture improved the total effective rate of patients with postoperative pain compared with the conventional treatment[OR=4.42,95%CI(2.60,7.50),P<0.001].The consumption of postoperative analgesia pump was reduced[MD=-9.03,95%CI(-12.09,-5.98),P<0.001],and the postoperative pain VAS score decreased[MD=-1.39,95%CI(-1.68,-1.09),P<0.001].The incidence of adverse reactions was reduced[RR=0.40,95%CI(0.32,0.48),P<0.001],and the clinical satisfaction increased[OR=3.94,95%CI(2.40,6.48),P<0.001].The result of Grade evidence grading showed that the three outcome indicators of total effective rate,incidence of adverse reactions and clinical satisfaction were medium-quality evidence;the postoperative pain VAS score index was low-quality evidence;and the index of analgesic pump use was extremely low-quality evidence.Conclusions The wrist-ankle acupuncture can improve the total effective rate,reduce the dosage of postoperative analgesics,with fewer adverse reactions and high safety,therefore providing a safe and effective analgesic method for patients.

关 键 词：腕踝针 术后疼痛 META分析 Grade评价 

分 类 号：R47[医药卫生—护理学]