针刺缓解术后疼痛的文献计量学分析

Bibliometric analysis of acupuncture relieving postoperative pain

中文关键词: 术后疼痛  针刺  随机对照试验  文献计量学

英文关键词: Postoperative pain  Acupuncture  Randomized controlled trial  Bibliometric

中文摘要:

      
目的 分析针刺缓解术后疼痛相关随机对照试验（RCT）的研究现状。
方法 检索PubMed、Cochrane、Embase、Web of Science、CBM和CNKI数据库，获取从建库至2019年5月收录的相关文献。
结果 纳入针刺缓解术后疼痛的RCT文献共198篇，研究者主要来自中国（66.7%），多分布于麻醉科（30.3%）、针灸科（12.9%）、肛肠科（6.5%）。电针（46.5%）最为常用，针刺穴位多选用合谷（30.3%）、足三里（25.3%）和内关（18.7%）。92.4%的研究证实针刺可以缓解术后疼痛；仅8.6%的研究提及试验注册；37.4%的研究提及针刺操作者资质。电针缓解术后疼痛的有效率高于手捻针，而在减少镇痛药用量、延缓首次用药时间及降低术后不良反应发生率方面，其有效率均低于手捻针。73.7%的研究因样本量估算不达标而被评估为高偏倚风险。
结论 针刺缓解术后疼痛的RCT在试验注册、操作者资质、针刺操作细节等方面报告率较低，不同针刺技术缓解术后疼痛各具优劣，后续研究可参考CONSORT 2010和STRICTA提高证据报告质量，同时开展不同针刺技术的疗效比较研究，以寻找最佳镇痛方案。

英文摘要:

      
Ojective To analyze the current status and trends of randomized controlled trials (RCTs) on the ability of acupuncture to alleviate postoperative pain.
Methods RCTs on acupuncture for alleviation postoperative pain were collected from PubMed, Cochrane Library, Embase, Web of Science, CBM and China National Knowledge Infrastructure (CNKI) database, and the retrieved trials published from the time when the respective databases were built to May 2019.
Results A total of 198 RCTs on the ability of acupuncture to alleviate postoperative pain were finally included in the analysis, most of which were distributed in the department of anesthesiology (30.3%), acupuncture (12.9%) and anorectal department (6.5%). The researchers mainly came from China (66.7%). Electro acupuncture (46.5%) was the most commonly used, acupuncture points were mainly Hegu (30.3%), Zusanli (25.3%), and Neiguan (18.7%). 92.4% of the studies confirmed that acupuncture could relieve postoperative pain. However, only 8.6% of the studies mentioned trial registration. 37.4% of the studies mentioned acupuncture technical operator qualification. The effective rate of electro acupuncture in relieving postoperative pain was higher than that of manual acupuncture, while the effective rate in reducing the consumption of analgesics, delaying time of first use of analgesics and reducing the incidence of postoperative adverse reactions were lower than that of manual acupuncture. 73.7% of the studies were assessed as high risk bias due to substandard sample size.
Conclusion RCT of acupuncture relieving postoperative pain is less reporteel in terms of test registration, operator qualification and details of acupuncture operation. Different acupuncture techniques have their own advantages and disadvantages in relieving postoperative pain. For follow-up study, we can refer to CONSORT 2010 and STRICTA to improve the quality of evidence report, and comparative study on the efficacy of different acupuncture techniques needs to be carried out to find the best analgesic measures.