Meta-analysis of acustimulation effects on nausea and vomiting in pregnant women
Meta-analysis of acustimulation effects on nausea and vomiting in pregnant women
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DOI：
10.1016/j.explore.2006.06.002
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发表时间：
2006-09-01
影响因子：
2.4
通讯作者：
Dune, Linda S.
中科院分区：
文献类型：
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作者：
Helmreich, Rebecca Jo;Shiao, Shyang-Yun Pamela K.;Dune, Linda S.
目的：我们使用荟萃分析来检验针刺激（AS）对预防孕妇恶心呕吐（NVP）的影响。方法：对针刺激（即指压、针灸和电刺激[ETS]）对NVP的影响进行荟萃分析。根据随机对照试验荟萃分析 (QUORUM) 指南的报告质量，对过去 16 年发表的 14 项试验、8 项随机对照试验 (RCT)（其中一项 RCT 具有 4 组的两种治疗方式）和 6 项交叉对照试验 (N = 1655) 进行了质量评估。相对风险 (RR) 和 95% 置信区间 (CI) 是根据原始试验研究者提供的数据计算的。 结果：治疗前，100% 的女性（13 项试验，n = 1615 名女性）出现恶心，但 96.6% (1599/1655) 报告呕吐。治疗后，与对照组相比，AS（所有治疗方式相结合）减少了恶心（RR = 0.47，95% CI：0.35-0.62，P < .0001）和呕吐（RR = 0.59，95% CI：0.51-0.68，P < .0001）的比例。通过手指压力或腕带应用的指压法可减少 NVP。 ETS 方法对于降低 NVP 也很有效。然而，针灸方法没有显示出降低 NVP 的效果。与对照组相比，在减少恶心（三项试验，RR = 0.63，95% CI：0.39-1.02，P = .0479）和呕吐（五项试验，RR = 0.67，95% CI：0.50-0.91，P = .0084）方面存在安慰剂效应。 结论：这项荟萃分析表明，指压按摩和 ETS 的影响比针灸方法治疗NVP。然而，针对孕妇的针灸试验数量有限，可能是因为不可能自行进行针灸，因此对于患有 NVP 慢性症状的女性来说不方便。
Objective: We used meta-analysis to examine the effects of acustimulation (AS) on the prevention of nausea and vomiting in pregnant women (NVP).Methods: Meta-analysis of effects of acustimulations (ie, acupressure, acupuncture, and electrical stimulation [ETS]) on NVP was conducted. Fourteen trials, eight random controlled trials (RCTs), with one RCT having two treatment modalities with four groups, and six crossover controlled trials (N = 1655) published over the last 16 years were evaluated for quality according to the Quality of Reports of Meta-analysis of Randomized Controlled Trials (QUORUM) guidelines. Relative risks (RR) and 95% confidence intervals (CI) were calculated from the data provided by the investigators of the original trials.Results: Before the treatment, 100% of the women (13 trials, n = 1615 women) were nauseated, but and 96.6% (1599/1655) reported vomiting. After the treatment, compared with the controls, AS (all modalities combined) reduced the proportion of nausea (RR = 0.47, 95% CI: 0.35-0.62, P < .0001) and vomiting (RR = 0.59, 95% CI: 0.51-0.68, P < .0001). Acupressure methods applied by finger pressure or wristband reduced NVP. The ETS method was also effective in reducing NVP. However the acupuncture method did not show effects on reducing NVP. There was a placebo effect when compared with controls in reducing nausea (three trials, RR = 0.63, 95% Cl: 0.39-1.02, P = .0479) and vomiting (five trials, RR = 0.67, 95% CI: 0.50-0.91, P = .0084).Conclusions: This meta-analysis demonstrates that acupressure and ETS had greater impact than the acupuncture methods in the treatment of NVP. However, the number of acupuncture trials was limited for pregnant women, perhaps because it is impossible to self-administer the acupuncture and thus inconvenient for women experiencing NVP as chronic symptoms.