中西医结合护理 (May 2021)
Meta analysis of Zusanli (ST36) acupoint injection of Neostigmine in the treatment of postoperative abdominal distention (足三里穴位注射新斯的明治疗术后腹胀的Meta分析)
Abstract
Objective To systematically evaluate the efficacy of Zusanli(ST36) acupoint injection of Neostigmine in the treatment of postoperative abdominal distention, and to provide evidence-based basis for the nursing and treatment of postoperative abdominal distention. Methods Randomized controlled trials (RCT) of Zusanli acupoint injection of Neostigmine for postoperative abdominal distention was searched in CNKI, Wanfang Data, VIP, PubMed and Embase. After literature screening, data extraction and quality evaluation were completed by two researchers independently, the Review Manager 5. 3 software was used for Meta analysis. Results A total of 1622 patients were enrolled in 17 RCT studies. Meta analysis showed that the total effective rate of Zusanli acupoint injection of Neostigmine was higher than that in the control group(OR= 7. 49, 95%CI［4. 66, 12. 05］, P<0. 01), and Zusanli acupoint injection of Neostigmine was associated with a shorter exhaust time (SMD=-2. 07, 95% CI［- 3. 13, - 1. 00］, P<0. 01). Conclusion Zusanli acupoint injection of Neostigmine has a better therapeutic effect on postoperative abdominal distention than conventional treatment. However, there was a high heterogeneity in the literature when evaluating the first anal exhaust time, which may be related to different surgical methods, different surgical sites and different doses of neostigmine. More high-quality prospective multicenter randomized controlled trials are needed to provide more reliable evidence for clinical practice. (目的 系统评价足三里穴位注射新斯的明治疗术后腹胀的效果, 为临床术后腹胀的治疗和护理提供循证依据。方法 计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang Data)、维普期刊全文数据库(VIP)、PubMed、Embase中关于足三里穴位注射新斯的明治疗术后腹胀的临床随机对照试验(RCT), 检索时限为建库至2020年4月。由2名研究者独立完成进行文献筛选、数据提取和质量评价后, 采用Review Manager 5. 3软件进行Meta分析。结果 共纳入17项RCT研究, 1622例患者。Meta分析结果显示, 新斯的明用于足三里穴位注射治疗术后腹胀的总有效率高于对照组［OR=7. 49, 95%CI(4. 66, 12. 05), P<0. 01］, 肛门排气时间短于对照组［SMD=-2. 07, 95%CI(-3. 13, -1. 00), P<0. 01］。结论 足三里穴位注射新斯的明治疗术后腹胀有较好的治疗效果, 效优于常规治疗。但评价肛门首次排气时间时文献呈现高度异质性, 可能与手术方法不同、手术部位不同、新斯的明用药剂量不同相关, 尚需更多高质量的前瞻性多中心随机对照研究为临床提供更可靠的证据。)
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