| Objective:Through objectively evaluating the clinical efficacy of acupoint catgut embedding in the treatment of functional constipation by Meta-analysis,this dissertation provides an objective evidence-based basis and therapeutic reference for the clinical application of acupoint catgut embedding in the treatment of this disease.Methods:According to the pre-established search strategy,the clinical randomized controlled trials of acupoint catgut embedding in the treatment of functional constipation in domestic and foreign databases from the establishment of the database to December 31,2021 were searched.The subjects of the study were patients with definite diagnosis of functional constipation.The control group was treated with drug,and the experimental group was treated with acupoint catgut embedding or acupoint catgut embedding on the basis of the control group.Outcome measures included total effective rate,score of defecation difficulty degree,score of Bristol fecal traits,sore of defecation interval time,score of single defecation time,residual number of gastrointestinal transmis-sion test markers after 72 h,and adverse reactions.The retrieved literature were imported into Note Express software for strict screening according to the inclusion and exclusion criteria,and the literature that met the criteria were finally included in the Meta study.After extracting relevant data through Excel,the risk of bias assessment criteria provided by the Cochrane Collaboration were applied to evaluate the methodological quality of the included literature,and the outcome index data were imported into Revman5.4 and Stata SE 16 software for Meta-analysis.Results:Twenty-eight papers were selected and finally included in this study,all of which were Chinese literature.Among them,the intervention measures of19 papers were acupoint catgut embedding VS drug,and the intervention measures of 9 papers were acupoint catgut embedding plus drugs VS drugs.A total of 2166 patients with functional constipation were included,and 1083 patients in the experimental group and the control group respectively.(1)Acupoint catgut embedding VS drug:(1)Total effective rate: Acupoint catgut embedding had an advantage over drug treatment in improving the total effective rate,RR=1.17,95%CI(1.11,1.24),P< 0.00001;(2)Score of defecati-on difficulty degree: The improvement of difficulty in defecation after acupoint catgut embedding therapy was better than drug treatment,SMD=-2.26,95%CI(-3.54,-0.99),P=0.0005 < 0.05;(3)Score of Bristol fecal traits:Acupoint catgut embedding has advantages over drug treatment in improving fecal traits,MD=-0.20,95%CI(-0.24,-0.16),P < 0.00001;(4)Score of defecation interval time: Acupoint catgut embedding has some advantages over drug treatment in shortening the interval time of defecation,SMD=-0.32,95%CI(-0.56,-0.07),P=0.01 < 0.05;(5)Score of single defeca-tion time: The effect of acupoint catgut embedding on shortening defecation time was better than drug treatment,MD=-0.58,95%CI(-0.82,-0.34),P <0.00001;(6)Residual number of gastrointestinal transmission test markers after 72h: Acupoint catgut embedding combined with drug therapy was superior to drug therapy in reducing the number of residual of gastrointestinal transit test markers after 72 h,MD=-4.13,95%CI(-4.47,-3.8),P< 0.00001.(2)Acupoint catgut embedding plus drugs VS Drugs:(1)Total effective rate: Acupoint catgut embedding combined with drug therapy was more significant in improving the total effective rate than drug therapy alone,RR=1.18,95% CI(1.11,1.25),P < 0.00001;(2)Score of defecation difficulty degree: Acupoint catgut embedding combined with drug therapy improved the symptoms of difficult defecation more obviously than drug therapy alone,MD=-0.63,95%CI(-0.81,-0.45),P< 0.00001;(3)Score of Bristol fecal traits:Acupoint catgut embedding combined with drug therapy had superiority over drug therapy in improving fecal traits,MD=-0.68,95%CI(-0.95,-0.42),P <0.00001;(4)Score of defecation interval time: Acupoint catgut embedding combined with drug therapy was more significant than simple drug therapy in improving the interval time of defecation,SMD=-0.79,95%CI(-1.04,-0.53),P < 0.00001;(5)Score of single defecation time: Acupoint catgut embedding combined with drug therapy was superior in shortening the time of a single defecation compared with drug therapy alone,MD=-0.45,95%CI(-0.57,-0.32),P < 0.00001;(6)Residual number of gastrointestinal transmission test markers after 72h: Acupoint catgut embedding combined with drug therapy was superior to drug therapy in reducing the number of residual of gastrointestinal transit test markers after 72 h,SMD=-0.68,95%CI(-2.13,-1.23),P< 0.00001.(3)Adverse reactions: Adverse reactions were reported in 8 of the 28 included studies,including mild diarrhea and unformed stool in the drug group and mild swelling and pain,redness and fever in the embedding group.No serious adverse reactions were observed in all studies,and all symptoms resolved spontaneously with fair safety.Conclusion:1.Acupoint catgut embedding and acupoint catgut embedding combined with drug therapy had certain curative effects in the treatment of functional constipation,and were superior to drug therapy only in improving the total effective rate of treatment2.Acupoint catgut embedding and acupoint catgut embedding combined with drug therapy can shorten the defecation interval and single defecation time of patients with functional constipation,improve he fecal traits and defecation difficulty symptoms,reduce the residual number of gastrointestinal transit test markers after 72 h,and the therapeutic effect is better than drug therapy alone. |
