摘要
目的 通过证据图分析方法系统梳理耳穴贴压技术在泌尿系统结石患者中应用的干预性研究,以了解该领域证据分布情况及研究存在的问题.方法 系统检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、CINAHL complete、Web of Science、Elsevier Science Direct、Embase等中英文数据库,筛选与耳穴贴压技术在泌尿系统结石患者中应用相关的研究,检索时限为数据库建库至2024年6月.分析纳入文献的发文量趋势、文献类型、文献内样本量、干预措施、选穴分布、结局指标及文献方法学质量.结果 本研究共纳入79篇文献,包含随机对照研究65篇,类实验性研究5篇,不清楚分组依据的研究9篇.总体发文量呈上升趋势,平均样本量为103.37例,最常选用的耳穴为肾、输尿管、交感、神门、膀胱等,关注较多的结局指标为临床疗效、疼痛缓解情况及结石排出情况等,总体纳入文献的方法学质量不高.结论 耳穴贴压技术在泌尿系统结石患者中的应用具有一定优势,穴位及结局指标的选择具有多样性,但多数研究在设计的科学性、干预措施的个性化及结局指标的测量与分析等方面存在不足,未来有待开展科学严谨的大样本、多中心的随机对照研究,为耳穴贴压技术在泌尿系统结石患者中的应用提供高质量的循证依据.
Abstract
Objective To systematically sort out the interventional studies on the application of auricular point sticking technique in patients with urinary calculi by means of evidence map analysis in order to understand the distribution of evidence in this field and the problems of the studies.Meth-ods Chinese and English databases such as CNKI,Wanfang,VIP,China Biology Medicine(CBM)Database,PubMed,Cochrane Library,CINAHL complete,Web of Science,Elsevier Science Direct,Embase,etc.were systematically searched to screen for studies related to the application of auricular point sticking technique in patients with urinary calculi.The time frame of the review was from the database construction to June 2024,and the trend of publication,type of literature,sample size in the literature,interventions,distribution of acupuncture points,outcome indexes,and methodological quality of the literature were analyzed by using graphs and text.Results A total of 79 papers were included,including 65 randomized controlled studies,5 quasi-experimental study,and 9 studies with unclear grouping basis.The overall trend of the number of publications was increasing,and the aver-age sample size was 103.37 patients.The most frequently selected auricular acupuncture points were kidney,ureter,sympathetic point,Shenmen,and bladder,etc.,and the endpoint indicators of greater concern were clinical efficacy,pain relief,and stone expulsion,etc.The methodological quality of the literature was not high.Conclusion Auricular point sticking technique has certain ad-vantages in the treatment of urinary calculi,and the selection of acupoints and outcome indicators are diverse.However,most studies have shortcomings in scientific research design,personalized intervention measures,measurement and analysis of outcome indicators,etc.Therefore,more scientific and rigorous large-scale,multi-center randomized controlled studies are needed in the future to provide high-quality evidence-based basis for the application of auricular point sticking technique in patients with urinary calculi.
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