Invasive acupuncture for gastroparesis after thoracic or abdominal surgery: a systematic review and meta-analysis

作者全名："Fan, Zhenjia; Qiu, Yuqin; Qi, Xuewei; Xu, Jingnan; Wan, Yuxiang; Hao, Yingxu; Niu, Wenquan; Huang, Jinchang"

作者地址："[Fan, Zhenjia; Qi, Xuewei; Xu, Jingnan; Wan, Yuxiang; Huang, Jinchang] Beijing Univ Chinese Med, Affiliated Hosp 3, Dept Minimally Invas Acupuncture Oncol, Beijing, Peoples R China; [Qiu, Yuqin] Chongqing Med Univ, Affiliated Hosp 1, Dept Integrated Tradit Chinese & Western Med, Chongqing, Peoples R China; [Hao, Yingxu] China Japan Friendship Hosp, Oncol Dept Integrated Tradit Chinese & Western Med, Beijing, Peoples R China; [Niu, Wenquan] Capital Inst Pediat, Ctr Evidence Based Med, Beijing, Peoples R China"

通信作者："Huang, JC (通讯作者)，Beijing Univ Chinese Med, Affiliated Hosp 3, Dept Minimally Invas Acupuncture Oncol, Beijing, Peoples R China."

来源：BMJ OPEN

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001034602300033

JCR分区：Q1

影响因子：2.4

年份：2023

卷号：13

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：COMPLEMENTARY MEDICINE; Motility disorders; STATISTICS & RESEARCH METHODS; SURGERY

摘要："ObjectivesThis meta-analysis aimed to systematically evaluate the efficacy of acupuncture in treating postsurgical gastroparesis syndrome (PGS) after thoracic or abdominal surgery. DesignSystematic review and meta-analysis. Data sourcesTwelve databases (PubMed, Embase, Cochrane Library Cochrane Central Register of Controlled Trials (CENTRAL), Medline (Ovid) (from 1946), Web of Science, EBSCO, Scopus, Open Grey, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Scientific Journals Database (VIP) and China Biology Medicine disc (CBM)) and three registration websites (WHO International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and Chinese Clinical Trial Registry (ChiCTR)) were searched from the inception to September 2022, and citations of the included literature were screened. Eligibility criteriaAll randomised controlled trials addressing invasive acupuncture for PGS. Data extraction and synthesisKey information on the included studies was extracted by two reviewers independently. Risk ratio (RR) with 95% CI was used for categorical data, and mean difference with 95% CI for continuous data. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Outcomes were conducted with trial sequential analysis (TSA). ResultsFifteen studies with 759 patients met the inclusion criteria. Subgroup analyses revealed that compared with the drug group, the drug and acupuncture group had a greater positive effect on the total effective rate (TER) (nine trials, n=427; RR=1.20; 95% CI 1.08 to 1.32; P-heterogeneity=0.20, I-2=28%, p=0.0004) and the recovery rate (RCR) (six trials, n = 294; RR = 1.61; 95% CI 1.30 to 1.98; P-heterogeneity=0.29, I-2=19%, p<0.0001) of PGS after abdominal surgery. However, acupuncture showed no significant advantages in terms of the TER after thoracic surgery (one trial, p=0.13) or thoracic/abdominal surgery-related PGS (two trials, n = 115; RR=1.18; 95% CI 0.89 to 1.57; P-heterogeneity=0.08, I-2=67%, p=0.24) and the RCR after thoracic/abdominal surgery (two trials, n=115; RR=1.40; 95% CI 0.97 to 2.01; P-heterogeneity=0.96, I-2=0%, p=0.07). The quality of evidence for TER and RCR was moderate certainty. Only one study reported an acupuncture-related adverse event, in the form of mild local subcutaneous haemorrhage and pain that recovered spontaneously. TSA indicated that outcomes reached a necessary effect size except for clinical symptom score. ConclusionBased on subgroup analysis, compared with the drug treatment, acupuncture combined drug has significant advantages in the treatment of PGS associated with abdominal surgery, but not with thoracic surgery. PROSPERO registration numberCRD42022299189."

基金机构："Key Research Project of Beijing University of Chinese Medicine [2020- JYB-ZDGG- 143-1]; National Natural Science Foundation of China [82074545]; Hospital -level Cultivation Project of the Third Affiliated Hospital of Beijing University of Chinese Medicine [BZYSY- 2022-PYQN-05]; Project of Famous Doctor Inheritance Workstation of Zhang Daizhao,3+3' Project of Beijing Traditional Chinese Medicine Inheritance [2007-SZ-C-12]"

基金资助正文："This work was supported by Key Research Project of Beijing University of Chinese Medicine (Grant Number 2020- JYB-ZDGG- 143-1), National Natural Science Foundation of China (Grant Number 82074545), Hospital -level Cultivation Project of the Third Affiliated Hospital of Beijing University of Chinese Medicine (Grant Number BZYSY- 2022-PYQN-05), Project of Famous Doctor Inheritance Workstation of Zhang Daizhao,3+3' Project of Beijing Traditional Chinese Medicine Inheritance (Grant Number 2007-SZ-C-12)."