PDF(Pubmed)
Abstract：
UNASSIGNED: This study aims to evaluate the efficacy and safety of various acupuncture treatments in conjunction with multimodal analgesia (MA) for managing postoperative pain and improving knee function in patients undergoing total knee arthroplasty (TKA), based on the findings from clinical research indicating the potential benefits of acupuncture-related therapies in this context.
UNASSIGNED: We searched Web of Science, PubMed, SCI-hub, Embase, Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Scientific Journal Database (VIP) to collect randomized controlled trials of acupuncture-related therapies for post-TKA pain. After independent screening and data extraction, the quality of the included literature was evaluated. The potential for bias in the studies incorporated in the analysis was assessed according to the guidelines outlined in the Cochrane Handbook 5.1. Network meta-analysis (NMA) was conducted using RevMan 5.4 and Stata 16.0 software, with primary outcome measures including visual analog scale (VAS), pain pressure threshold (PPT), hospital for special surgery knee score (HSS), and knee joint range of motion (ROM). Furthermore, the interventions were ranked based on the SUCRA value.
UNASSIGNED: We conducted an analysis of 41 qualifying studies encompassing 3,003 patients, examining the efficacy of four acupuncture therapies (acupuncture ACU, electroacupuncture EA, transcutaneous electrical acupoint stimulation TEAS, and auricular acupoint therapy AAT) in conjunction with multimodal analgesia (MA) and MA alone. The VAS results showed no significant difference in efficacy among the five interventions for VAS-3 score. However, TEAS+MA (SMD: 0.67; 95%CI: 0.01, 1.32) was more effective than MA alone for VAS-7 score. There was no significant difference in PPT score among the three interventions. ACU + MA (SMD: 6.45; 95%CI: 3.30, 9.60), EA + MA (SMD: 4.89; 95%CI: 1.46, 8.32), and TEAS+MA (SMD: 5.31; 95%CI: 0.85, 9.78) were found to be more effective than MA alone for HSS score. For ROM score, ACU + MA was more efficacious than EA + MA, TEAS+MA, and AAT + MA, MA. Regarding the incidence of postoperative adverse reactions, nausea and vomiting were more prevalent after using only MA. Additionally, the incidence of postoperative dizziness and drowsiness following ACU + MA (OR = 4.98; 95%CI: 1.01, 24.42) was observed to be higher compared to that after AAT + MA intervention. Similarly, the occurrence of dizziness and drowsiness after MA was found to be significantly higher compared to the following interventions: TEAS+MA (OR = 0.36; 95%CI: 0.18, 0.70) and AAT + MA (OR = 0.20; 95%CI: 0.08, 0.50). The SUCRA ranking indicated that ACU + MA, EA + MA, TEAS+MA, and AAT + MA displayed superior SUCRA scores for each outcome index, respectively.
UNASSIGNED: For the clinical treatment of post-TKA pain, acupuncture-related therapies can be selected as a complementary and alternative therapy. EA + MA and TEAS+MA demonstrate superior efficacy in alleviating postoperative pain among TKA patients. ACU + MA is the optimal choice for promoting postoperative knee joint function recovery in TKA patients. AAT + MA is recommended for preventing postoperative adverse reactions.
UNASSIGNED: https://www.crd.york.ac.uk/, identifier (CRD42023492859).
UNASSIGNED: We searched Web of Science, PubMed, SCI-hub, Embase, Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Scientific Journal Database (VIP) to collect randomized controlled trials of acupuncture-related therapies for post-TKA pain. After independent screening and data extraction, the quality of the included literature was evaluated. The potential for bias in the studies incorporated in the analysis was assessed according to the guidelines outlined in the Cochrane Handbook 5.1. Network meta-analysis (NMA) was conducted using RevMan 5.4 and Stata 16.0 software, with primary outcome measures including visual analog scale (VAS), pain pressure threshold (PPT), hospital for special surgery knee score (HSS), and knee joint range of motion (ROM). Furthermore, the interventions were ranked based on the SUCRA value.
UNASSIGNED: We conducted an analysis of 41 qualifying studies encompassing 3,003 patients, examining the efficacy of four acupuncture therapies (acupuncture ACU, electroacupuncture EA, transcutaneous electrical acupoint stimulation TEAS, and auricular acupoint therapy AAT) in conjunction with multimodal analgesia (MA) and MA alone. The VAS results showed no significant difference in efficacy among the five interventions for VAS-3 score. However, TEAS+MA (SMD: 0.67; 95%CI: 0.01, 1.32) was more effective than MA alone for VAS-7 score. There was no significant difference in PPT score among the three interventions. ACU + MA (SMD: 6.45; 95%CI: 3.30, 9.60), EA + MA (SMD: 4.89; 95%CI: 1.46, 8.32), and TEAS+MA (SMD: 5.31; 95%CI: 0.85, 9.78) were found to be more effective than MA alone for HSS score. For ROM score, ACU + MA was more efficacious than EA + MA, TEAS+MA, and AAT + MA, MA. Regarding the incidence of postoperative adverse reactions, nausea and vomiting were more prevalent after using only MA. Additionally, the incidence of postoperative dizziness and drowsiness following ACU + MA (OR = 4.98; 95%CI: 1.01, 24.42) was observed to be higher compared to that after AAT + MA intervention. Similarly, the occurrence of dizziness and drowsiness after MA was found to be significantly higher compared to the following interventions: TEAS+MA (OR = 0.36; 95%CI: 0.18, 0.70) and AAT + MA (OR = 0.20; 95%CI: 0.08, 0.50). The SUCRA ranking indicated that ACU + MA, EA + MA, TEAS+MA, and AAT + MA displayed superior SUCRA scores for each outcome index, respectively.
UNASSIGNED: For the clinical treatment of post-TKA pain, acupuncture-related therapies can be selected as a complementary and alternative therapy. EA + MA and TEAS+MA demonstrate superior efficacy in alleviating postoperative pain among TKA patients. ACU + MA is the optimal choice for promoting postoperative knee joint function recovery in TKA patients. AAT + MA is recommended for preventing postoperative adverse reactions.
UNASSIGNED: https://www.crd.york.ac.uk/, identifier (CRD42023492859).
摘要：
■本研究旨在评估各种针灸治疗联合多模式镇痛（MA）的疗效和安全性，以管理全膝关节置换术（TKA）患者的术后疼痛和改善膝关节功能，基于临床研究的结果，表明在这种情况下针灸相关疗法的潜在益处。
■我们搜索了WebofScience,PubMed,SCI-hub,Embase,科克伦图书馆,中国生物医学（CBM），中国国家知识基础设施(CNKI),万方数据,和中国科学期刊数据库（VIP）收集TKA后疼痛的针灸相关疗法的随机对照试验。经过独立筛选和数据提取，对纳入文献的质量进行评价.根据Cochrane手册5.1中概述的指南评估分析中纳入的研究中的偏差可能性。使用RevMan5.4和Stata16.0软件进行网络荟萃分析(NMA)，主要结局指标包括视觉模拟量表（VAS），疼痛压力阈值（PPT），医院特殊手术膝关节评分（HSS），和膝关节运动范围（ROM）。此外，干预措施根据SUCRA值进行排名.
■我们对包括3,003名患者的41项合格研究进行了分析。检查四种针灸疗法的疗效(针灸ACU，电针EA，经皮穴位电刺激TEAS，和耳穴疗法AAT）联合多模式镇痛（MA）和单独的MA。VAS结果显示，五种干预措施对VAS-3评分的疗效没有显着差异。然而,TEAS+MA(SMD:0.67;95CI:0.01,1.32)对于VAS-7评分比单独使用MA更有效。3种干预措施的PPT评分差异无统计学意义。ACU+MA(SMD:6.45;95CI:3.30,9.60),EA+MA（SMD：4.89；95CI：1.46，8.32），发现TEAS+MA(SMD:5.31;95CI:0.85,9.78)对HSS评分比单独使用MA更有效。对于ROM分数，ACU+MA比EA+MA更有效，TEAS+MA,和AAT+MA，关于术后不良反应的发生率，仅使用MA后,恶心和呕吐更为普遍.此外,与AAT+MA干预后相比,ACU+MA术后头晕和嗜睡的发生率更高(OR=4.98;95CI:1.01,24.42).同样，与以下干预措施相比,发现MA后头晕和嗜睡的发生率明显更高:TEAS+MA(OR=0.36;95CI:0.18,0.70)和AAT+MA(OR=0.20;95CI:0.08,0.50).SUCRA排名表明ACU+MA，EA+MA,TEAS+MA,AAT+MA显示每个结果指数的SUCRA得分较高，分别。
■对于TKA术后疼痛的临床治疗，针灸相关疗法可以选择作为补充和替代疗法。EA+MA和TEAS+MA在减轻TKA患者术后疼痛方面表现出优异的疗效。ACU+MA是促进TKA患者术后膝关节功能恢复的最佳选择。建议使用AAT+MA预防术后不良反应。
■https://www.crd.约克。AC.英国/,标识符(CRD42023492859)。
■我们搜索了WebofScience,PubMed,SCI-hub,Embase,科克伦图书馆,中国生物医学（CBM），中国国家知识基础设施(CNKI),万方数据,和中国科学期刊数据库（VIP）收集TKA后疼痛的针灸相关疗法的随机对照试验。经过独立筛选和数据提取，对纳入文献的质量进行评价.根据Cochrane手册5.1中概述的指南评估分析中纳入的研究中的偏差可能性。使用RevMan5.4和Stata16.0软件进行网络荟萃分析(NMA)，主要结局指标包括视觉模拟量表（VAS），疼痛压力阈值（PPT），医院特殊手术膝关节评分（HSS），和膝关节运动范围（ROM）。此外，干预措施根据SUCRA值进行排名.
■我们对包括3,003名患者的41项合格研究进行了分析。检查四种针灸疗法的疗效(针灸ACU，电针EA，经皮穴位电刺激TEAS，和耳穴疗法AAT）联合多模式镇痛（MA）和单独的MA。VAS结果显示，五种干预措施对VAS-3评分的疗效没有显着差异。然而,TEAS+MA(SMD:0.67;95CI:0.01,1.32)对于VAS-7评分比单独使用MA更有效。3种干预措施的PPT评分差异无统计学意义。ACU+MA(SMD:6.45;95CI:3.30,9.60),EA+MA（SMD：4.89；95CI：1.46，8.32），发现TEAS+MA(SMD:5.31;95CI:0.85,9.78)对HSS评分比单独使用MA更有效。对于ROM分数，ACU+MA比EA+MA更有效，TEAS+MA,和AAT+MA，关于术后不良反应的发生率，仅使用MA后,恶心和呕吐更为普遍.此外,与AAT+MA干预后相比,ACU+MA术后头晕和嗜睡的发生率更高(OR=4.98;95CI:1.01,24.42).同样，与以下干预措施相比,发现MA后头晕和嗜睡的发生率明显更高:TEAS+MA(OR=0.36;95CI:0.18,0.70)和AAT+MA(OR=0.20;95CI:0.08,0.50).SUCRA排名表明ACU+MA，EA+MA,TEAS+MA,AAT+MA显示每个结果指数的SUCRA得分较高，分别。
■对于TKA术后疼痛的临床治疗，针灸相关疗法可以选择作为补充和替代疗法。EA+MA和TEAS+MA在减轻TKA患者术后疼痛方面表现出优异的疗效。ACU+MA是促进TKA患者术后膝关节功能恢复的最佳选择。建议使用AAT+MA预防术后不良反应。
■https://www.crd.约克。AC.英国/,标识符(CRD42023492859)。
