不同中医外治法促进妇科腹腔镜术后患者胃肠功能恢复网状Meta分析  

A Network Meta-Analysis of Different External Treatment Methods of Chinese Medi⁃cine Promoting Gastrointestinal Function Recovery in Patients After Gynecological Laparoscopic Surgery

作　　者：陈绅铭 范朝逢 曾雅静 陈小凤 肖静 CHEN Shenming;FAN Zhaofeng;ZENG Yajing;CHEN Xiaofeng;XIAO Jing(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China;Department of Gynecology,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]广州中医药大学第二附属医院妇科,广东广州510006

出　　处：《新中医》2024年第19期192-198,共7页New Chinese Medicine

基　　金：广东省中医院中医药科学技术研究专项(YN2022QN23)。

摘　　要：目的:通过网状Meta分析比较妇科腹腔镜手术后不同中医外治方法促进术后胃肠功能恢复的有效性。方法:检索7个中英文数据库从建库起至2023年9月,按照预先制订的纳入与排除标准筛选文献,采用Revman5.4和Stata14.0软件分别进行质量评价和网状Meta分析。结果:共纳入75项试验,涉及8451名参与者,纳入的中医外治法包括揿针、电针、普通针刺、艾灸、穴位按摩、穴位贴敷、穴位埋线、耳穴压豆、热奄包。网状Meta分析结果显示在缩短首次肠鸣音恢复时间、首次排气时间方面,相比其余8种中医外治法,灸法成为最佳方案的概率最大;在缩短患者首次排便时间方面,相比穴位按摩、穴位贴敷、揿针、耳穴压豆、灸法、电针,热奄包成为最佳方案的概率最大;在改善患者恶心呕吐方面,相比灸法、穴位埋线、热奄包、穴位贴敷、耳穴压豆、电针,穴位按摩减少恶心呕吐发生的可能性最高。结论:各中医外治法联合术后常规管理在促进妇科腹腔镜手术患者胃肠功能恢复方面有效可行。在9种中医外治法中,灸法更能尽快缩短首次肠鸣音及首次排气时间,热奄包与穴位按摩分别在缩短首次排便时间及预防术后恶心呕吐方面较其余外治法更有优势。Objective:To compare the effectiveness of different external treatment methods of Chinese medicine in promoting postoperative gastrointestinal function recovery after gynecological laparoscopic surgery through network Meta-analysis.Methods:Seven Chinese and English databases were searched from their inception until September 2023,and references were screened according to the pre-established inclusion and exclusion criteria.Revman 5.4 and Stata14.0 software were used for quality evaluation and network Meta-analysis respectively.Results:A total of 75 trials were included,involving 8451 participants.The external treatment methods of Chinese medicine included thumb-tack needling,electroacupuncture,acupuncture,moxibustion,acupoint massage,acupoint application,acupoint embedding,auricular point seed-pressing and hot package.The results of network Meta-analysis showed that moxibustion had the highest probability of being the best solution in terms of shortening the first bowel sound recovery time and the first exhaust time when compared with other eight external treatment methods of Chinese medicine.Compared with acupoint massage,acupoint application,auricular point seed-pressing,moxibustion and electroacupuncture,hot package was the most likely solution to shorten the first defecation time.In terms of improving nausea and vomiting,acupoint massage was found to be the most effective method when compared to moxibustion,acupoint embedding,hot package,acupoint application,auricular point seed-pressing,and electroacupuncture.Conclusion:The combination of various external treatment methods of Chinese medicine with routine postoperative management is effective and feasible in promoting the recovery of gastrointestinal function in patients after gynecological laparoscopic surgery.Among the nine external treatment methods of Chinese medicine,moxibustion was the most effective in shortening the time to first bowel sound and first exhaust.Hot package and acupoint massage were respectively more advantageous in shortening the first

关 键 词：腹腔镜手术 妇科 中医外治法 胃肠功能 网状Meta分析 

分 类 号：R614[医药卫生—麻醉学]