中医外治法缓解腹部术后腹胀有效性的网状Meta分析
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摘要
【目的】比较多种中医外治疗法缓解腹部术后腹胀的有效性。【方法】从PubMed、The Cochrane library和中国知网等中英文文献数据库中检索文献,根据文献的纳入和排除标准独立筛选文献、提取数据,并进行文献质量评价。采用R3.3.3分析软件进行网状Meta分析,比较各中医外治法的缓解腹胀有效率,并进行疗效排序概率(成为最佳治疗措施的概率)分析。【结果】共纳入22个研究,涉及7种治疗措施。分析结果显示艾灸、穴位按摩、穴位贴敷和穴位注射缓解腹胀有效率优于常规护理组,穴位贴敷成为最佳治疗措施的概率最大(P=0.976 9),为最优治疗措施。【结论】在常规护理基础上合理运用中医外治法尤其是穴位贴敷能有效缓解腹部术后腹胀症状。
Objective To compare the effectiveness of various external therapies of traditional Chinese medicine(TCM)in relieving abdominal distension after abdominal operation. Methods The literature was retrieved from the Chinese and English literature databases such as PubMed, the Cochrane library and CNKI. The literature was independently screened and then the data was extracted according to the inclusion criteria and exclusion criteria.The quality of the literature was evaluated. The network Meta-analysis was carried out with R3.3.3 software,and the effective rate of various TCM external therapies for relieving abdominal distension was compared, and the curative-effect probability(probability of being the optical therapy)was ranked. Results A total of 22 trials were included in the analysis, which involved 7 external therapies. The results showed that the curative effect of moxibustion, acupoint massage, acupoint application and acupoint injection was stronger than that of routine nursing method,and acupoint application had the highest probability of being the optical therapy(P = 0.976 9).Conclusion On the basis of routine nursing,reasonable application of proper TCM external treatment in particular acupoint application can effectively relieve abdominal distension after abdominal operation.
Objective To compare the effectiveness of various external therapies of traditional Chinese medicine(TCM)in relieving abdominal distension after abdominal operation. Methods The literature was retrieved from the Chinese and English literature databases such as PubMed, the Cochrane library and CNKI. The literature was independently screened and then the data was extracted according to the inclusion criteria and exclusion criteria.The quality of the literature was evaluated. The network Meta-analysis was carried out with R3.3.3 software,and the effective rate of various TCM external therapies for relieving abdominal distension was compared, and the curative-effect probability(probability of being the optical therapy)was ranked. Results A total of 22 trials were included in the analysis, which involved 7 external therapies. The results showed that the curative effect of moxibustion, acupoint massage, acupoint application and acupoint injection was stronger than that of routine nursing method,and acupoint application had the highest probability of being the optical therapy(P = 0.976 9).Conclusion On the basis of routine nursing,reasonable application of proper TCM external treatment in particular acupoint application can effectively relieve abdominal distension after abdominal operation.
引文
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[22]吴海华,余珍燕,梁伟玲.足三里穴位注射新斯的明治疗胃肠道术后腹胀的观察[J].国际医药卫生导报,2010,16(17):2151.
[23]曾桂英.中药敷脐治疗产科术后腹胀患者的临床护理(100例)[J].医疗装备,2017,30(17):178.
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[25]郑婵,梁瑜.维生素B1和新斯的明穴位注射治疗术后腹胀、尿潴留20例临床分析[J].中外医学研究,2014,12(20):44.
[26]蔡慎,于欢,郑英丽.足三里穴位注射新斯的明治疗手术后腹胀的Meta分析[J].中国医药,2015,10(3):381.
[27]李倩,汪永坚,王俊杰.艾灸对术后胃肠功能紊乱影响的Meta分析[J].护理研究,2017,31(15):4512.
[28]向玉萍,高静,赵霞,等.腹部术后穴位敷贴对促进胃肠功能恢复效果的系统评价[J].湖南中医杂志,2018,34(3):133.
[29]姚启娥,股淑华,魏婷.妇科患者术后穴位按摩与术后腹胀相关性研究[J].循证护理,2016,2(2):123.
[30]但小红.穴位注射足三里在改善直肠癌术后患者腹胀后的疗效观察[J].医药前沿,2017,7(19):311.
[2]王建萍,黄凌云,姜益,等.舒适护理干预对胃肠道手术患者胃肠蠕动功能恢复和护理满意度的影响[J].中国现代医生,2016,52(4):69.
[3] Jadad A R,Moore R A,Carroll D,et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary[J].Control Clin Trials,1996,17(1):1.
[4]蔡文,余小荣.新斯的明穴位注射治疗术后腹胀疗效观察[J].实用中医药杂志,2005,21(4):217.
[5]仇旋.足三里穴位注射新斯的明治疗妇科术后腹胀的疗效分析[J].河北中西医结合杂志,1997,6(1):94.
[6]范薇,黄蕾.脐疗法对剖宫产术后PCIA肠功能恢复的临床观察[J].西部医学,2008,20(5):1046.
[7]范雪燕.穴位贴敷治疗阑尾炎术后腹胀护理观察[J].山西中医,2014,30(3):59.
[8]奉逍.穴位盒灸治疗肛肠科术后腹胀的疗效观察[D].成都:成都中医药大学,2015.
[9]黄华勇.维生素B1足三里穴位注射治疗腹部手术后腹胀的疗效观察[J].医学信息,2009,22(10):2180.
[10]李江欣,肖静,李玉娟,等.穴位贴敷对剖宫产术后腹胀的护理效果观察[J].湖南中医杂志,2016,32(6):137.
[11]毛鲁瑛,奕香梅.新斯的明穴位注射治疗妇科术后腹胀74例[J].中国中医急症,2003,12(1):85.
[12]马袁玲.艾灸治疗腹部术后腹胀的效果观察[J].全科护理,2013,1(6):1541.
[13]任丹.艾灸治疗胃癌术后腹胀临床疗效观察[J].新中医,2016,48(11):184.
[14]沈梅芳,董兰聪,於国红.大黄粉加醋涌泉穴外敷治疗术后腹胀[J].浙江中西医结合杂志,2005,15(10):650.
[15]宋雅丽,王丽.穴位按摩对剖宫产术后肠道恢复的影响[J].当代护士,2015,23(9):76.
[16]唐翠卿,李燕,周靖凯.穴位按摩法在术后腹胀患者护理中运用的疗效观察[J].中国保健营养,2012,22(8):240.
[17]田春香,姜振娟,曲延文.新斯的明足三里注射治疗妇科术后腹胀的研究[J].青岛医药卫生,2007,39(4):267.
[18]王明月.酒调大黄粉神阔穴外敷促进术后肠蠕动恢复的临床研究[D].长春:长春中医药大学,2007.
[19]王淑瑛.穴位注射治疗腹部非胃肠手术后腹胀的疗效观察[J].中华全科医学,2010,8(10):1276.
[20]汪文珍.生大黄煎水保留灌肠治疗术后腹胀(肠麻痹)的临床体会[J].中国医药指南,2012,10(33):620.
[21]王小红.观察对剖宫产术后腹胀行穴位贴敷的护理效果[J].中外女性健康研究,2017,25(9):92.
[22]吴海华,余珍燕,梁伟玲.足三里穴位注射新斯的明治疗胃肠道术后腹胀的观察[J].国际医药卫生导报,2010,16(17):2151.
[23]曾桂英.中药敷脐治疗产科术后腹胀患者的临床护理(100例)[J].医疗装备,2017,30(17):178.
[24]张健,董荣坤,汪启斌,等.中药灌肠治疗胃肠术后腹胀疗效观察[J].湖北中医药大学学报,2015,17(2):82.
[25]郑婵,梁瑜.维生素B1和新斯的明穴位注射治疗术后腹胀、尿潴留20例临床分析[J].中外医学研究,2014,12(20):44.
[26]蔡慎,于欢,郑英丽.足三里穴位注射新斯的明治疗手术后腹胀的Meta分析[J].中国医药,2015,10(3):381.
[27]李倩,汪永坚,王俊杰.艾灸对术后胃肠功能紊乱影响的Meta分析[J].护理研究,2017,31(15):4512.
[28]向玉萍,高静,赵霞,等.腹部术后穴位敷贴对促进胃肠功能恢复效果的系统评价[J].湖南中医杂志,2018,34(3):133.
[29]姚启娥,股淑华,魏婷.妇科患者术后穴位按摩与术后腹胀相关性研究[J].循证护理,2016,2(2):123.
[30]但小红.穴位注射足三里在改善直肠癌术后患者腹胀后的疗效观察[J].医药前沿,2017,7(19):311.