Acupuncture Therapy For Preventing Postoperative Nausea And Vomiting:A Network Meta Analysis

Objective To systematically evaluate the prevention of acupuncture therapy on postoperative nausea and vomiting(PONV),and compare the effect differences among different therapies,in order to provide evidence-based medical basis for the prevention of PONV by acupuncture therapy.Methods Randomized controlled clinical trials of acupuncture therapy preventing PONV were collected.CNKI,Wanfang,VIP,CBM,Pub Med,Cochrane Library,Ebsco,Web of Science,Embase were searched by computer.Retrieval time from self-built database to June 2019.Risk bias and literature quality were evaluated for each included trial by two researchers.Cytoscape was used to draw the plot of intervention network,Review Manager 5.3 was used for general meta-analysis,and Addis 1.16.6 was used for network metaanalysis.Results: A total of 86 studies containing 9075 patients were included,among 3044 in placebo Group(PG),2106 in TEN Group(TG),1323 in Usual Care Group(UCG),1109 in Acupressure Group(APG),561 in 5HTRA Group(5HTG),586 in electroacupuncture Group(EAG),542 in acupuncture Group(ACG),229 in combination Group(CBG),194 in capsicum Group(CCG),137 in acupoint application Group(AAG).(1)Effects of the Whole Process The three most effective treatments in preventing PONV were CBG,5HTG and TG,all of them were statistically significant compared with UCG and PG.The three most effective treatments in preventing PON were EAG,CCG and CBG,all of them were statistically significant compared with UCG and PG.The three most effective treatments in preventing POV were EAG,CBG and CCG,all of them were statistically significant compared with UCG and PG.The three most effective methods for reducing POR were ACG,CBG and EAG,all of them were statistically significant compared with PG,ACG and CBG were statistically significant compared with UCG.(2)Effects of the Early Process The three most effective treatments in preventing PONV were EAG,CBG and UCG,all of them were statistically significant compared with PG.The three most effective treatments in preventing PON were CCG,AAG and TG,all of them were statistically significant compared with UCG and PG.The three most effective treatments in preventing POV were 5HTG,TG and CCG,5HTG and TG were statistically significant compared with PG.The three most effective methods for reducing POR were CCG,5HTG and TG,all of them weren't statistically significant compared with PG.(3)Effects of the Later Process The three most effective treatments in preventing PONV were CBG,5HTG and TG,all of them weren't statistically significant compared with PG.The three most effective treatments in preventing PON were 5HTG,AAG and UCG,all of them weren't statistically significant compared with PG.The three most effective treatments in preventing POV were TG,UCG and all of them weren't statistically significant.The three most effective methods for reducing POR were APG,TG and CBG,all of them weren't statistically significant compared with PG.Conclusion Acupuncture therapy can effectively prevent postoperative nausea and vomiting and reduce the use of postoperative remedial drugs.Combination therapy is the most effective measure.Considering the risk of heterogeneity and bias,the results of this study should be further verified clinically.