Objective: To systematically review the therapeutic effect of acupuncture and moxibustion on postoperative gastrointestinal dysfunction (GID) of gastric cancer with meta-analysis.
Methods: The articles of randomized controlled trials (RCTs) of acupuncture and moxibustion treatment for postoperative GID of gastric cancer were retrieved from the following databases from the time of database establishment to December 31, 2020, including PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database and China Biomedical Literature Database (SinoMed). RevMan5.3 software was used for meta-analysis. Using Stata16.0 software, sensitivity analysis and publication bias test were performed.
Results: A total of 16 RCTs were included finally, including 1 360 patients, of which, there were 681 cases in the intervention group and 679 cases in the control group. Meta-analysis results showed that acupuncture and moxibustion shortened the time of first flatus (P<0.000 01, MD =-14.52, 95%CI = [-17.31, -11.74]), the time of first bowel sound (P<0.000 01, MD =-10.50, 95%CI =[-13.99, -7.01]) and the time of first defecation (P<0.000 1, MD =-13.79, 95%CI =[-20.09, -7.50]). Meanwhile, acupuncture and moxibustion shortened the time of the first food intake (P<0.000 1, MD =-3.23, 95%CI = [-3.45, -3.00]) and the hospital stay (P<0.000 01, MD =-1.94, 95%CI =[-2.20, -1.69]) after gastric cancer operation, and reduced the incidences of postoperative adverse reactions, i.e. nausea and vomiting (P =0.000 3, RR =0.43, 95%CI =[0.28, 0.68]) and abdominal distention (P =0.000 5, RR =0.41, 95%CI =[0.25, 0.68]).
Conclusion: Acupuncture and moxibustion can promote the recovery of postoperative gastrointestinal function in the patients with gastric cancer. But, for the comparison among different measures of acupuncture and moxibustion intervention, it needs more high-quality trials for a further verification.
目的：运用Meta分析系统评价针灸治疗胃癌（GC）术后胃肠功能障碍（GID）的疗效。方法：计算机检索PubMed、EMbase、Cochrane协作网（CENTRAL）、中国期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang）、维普资讯中文期刊服务平台（VIP）及中国生物医学文献数据库（SinoMed）中针灸治疗GC术后GID 的随机对照试验（RCT）文献，检索时间从建库到2020年12月31日。利用RevMan5.3软件进行Meta分析，借助Stata16.0软件进行敏感性分析及发表偏倚检验。结果：最终纳入16篇文献，共1 360例患者，其中干预组681例，对照组679例。Meta分析结果表明针灸可缩短GC术后患者的首次排气时间（P<0.000 01，MD =-14.52，95%CI = [-17.31, -11.74]）、首次肠鸣音时间（P<0.000 01，MD =-10.50，95%CI =[-13.99, -7.01]）和首次排便时间（P<0.000 1，MD =-13.79，95% CI =[-20.09， -7.50]）。同时针灸可缩短GC术后患者首次进食时间（P<0.000 01，MD =-3.23，95%CI =[-3.45，-3.00]）和住院时间（P<0.000 01，MD =-1.94，95%CI =[-2.20，-1.69]），降低术后恶心呕吐（P =0.000 3，RR =0.43，95%CI =[0.28，0.68]）与腹胀（P =0.000 5，RR =0.41，95%CI =[0.25，0.68]）的发生率。结论：针灸能促进GC术后患者胃肠功能恢复，但不同针灸干预措施之间的比较还需纳入更多高质量的研究以进一步验证。.
Keywords: acupuncture and moxibustion; gastric cancer; gastrointestinal dysfunction; meta-analysis; systematic review.