| Objective:To evaluate the efficacy of Somatosensory stimulation treatments of postoperative pain of mixed hemorrhoids with Network Meta-Analysis,and to obtain the best treatment plan,promote the clinical application of somatosensory stimulation treatments of postoperative pain of mixed hemorrhoids,and optimize the treatment plan and path.Methods:Retrieve the Chinese biomedical database(CBM),China journal full-text database(CNKI),Ovid Medline,EMBASE and Cochrane Library,which is established based on the filtered into and exclusion criteria.Finally,107 literatures were included in the qualitative and quantitative analysis,and the data were extracted by using the Epi Info 7 software.The bias risk assessment tool in Cochrane handbook 5.1.0 was used to evaluate the quality of the included literature.R software netmeta package was used for statistical analysis of the extracted data.Standardized mean difference(SMD)was adopted to calculate the effect value of measurement data.The relative ratio(RR)was used to calculate the effect value.The 95% confidence interval(CI)of SMD and RR was calculated.The comprehensive Cochrane Q value was used for the descriptive analysis of the heterogeneity of the included trials,and the heterogeneity of the experimental effects was evaluated by the Z test.The network evidence relation diagram was made,the consistency of direct evidence and indirect evidence was compared by Z test,the probability of each intervention measure being the best was described by Pscore,and the best analgesia scheme of the somatosensory stimulation treatments was sorted and screened according to the probability.Results:In the end,107 articles were included,10,972 cases were included,and 40 kinds of intervention measures were included.The results of direct comparison and indirect comparison in most studies were comparable.The total effective rate of pain relief was taken as the outcome index,and the results of probability sequence showed that the top five were electric acupuncture,acupoint embedding,wrist-ankle acupuncture + auricular point pressing,gingival interfacial acupuncture + mild moxibustion,hand acupuncture + auricular point pressing in descending order.Pain scores were used as another outcome measure.From high to low,the top five are hand acupuncture + auricular point sticking pressure,electroacupuncture + acupoint wire embedding,electroacupuncture,acupoint wire embedding and hand acupuncture.Combined with the results of direct and Network Meta-Analysis of the above two outcome indicators,in the comparison of somatosensory stimulation treatments,electroacupuncture is superior to moxibustion with a box,auricular point sticking pressure,auricular point sticking pressure + mild moxibustion,auricular point sticking pressure + acupoint sticking,percutaneous nerve electrical stimulation,thermal moxibustion,hand acupuncture,acupoint sticking,gingival acupoint pointing + mild moxibustion;The curative effect of acupoint catgut embedding is better than auricular point sticking pressure,thermal moxibustion,hand acupuncture,percutaneous nerve electrical stimulation,acupoint application;Wrist-ankle acupuncture + auricular acupoint pressure is better than auricular acupoint pressure,percutaneous nerve electrical stimulation,gingival cross-puncture + mild moxibustion;Hand acupuncture + auricular point sticking pressure is better than auricular point sticking pressure,thermal moxibustion,hand acupuncture,percutaneous nerve electrical stimulation;Hand acupuncture is superior to auricular pressure;Auricular pressure is superior to conventional treatment.Conclusion:1.For the single measure,electroacupuncture,acupoint embedding,hand acupuncture,auricular point embedding,wrist-ankle acupuncture + auricular point embedding.For the mixed measure,gingival interfacial puncture + mild moxibustion,hand acupuncture + auricular point embedding,electroacupuncture + acupoint embedding may be effective treatment methods to alleviate postoperative pain of mixed hemorrhoids.2.Compared with opioids and NSAIDs,somatosensory stimulation treatments may be more conducive to relieve postoperative pain of mixed hemorrhoids. |
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