Acupuncture for the Postcholecystectomy Syndrome: A Systematic Review and Meta‐Analysis

Abstract

Background. Postcholecystectomy syndrome (PCS) has become a common postoperative syndrome that requires systematic and comprehensive therapy to achieve adequate clinical control. Acupuncture and related therapies have shown clinical effects for PCS in many studies. However, systematic reviews/meta-analyses (SRs/MAs) for them are lacking. Objective. To evaluate the efficacy and safety of acupuncture in the treatment of PCS using randomized controlled trials (RCTs). Methods. Potentially eligible studies were searched in the following electronic databases up to 1 February 2020: PubMed, Embase, Cochrane Library, Web of Science (WoS), Chinese databases (Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and China Science and Technology Journal Database (VIP)), and other sources (WHO ICTRP, ChiCTR, Clinical Trials, and Grey Literature Database). The RevMan 5.3 was employed for analyses. The Cochrane Collaboration’ risk of bias tool was used to assess the risk of bias (ROB). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence. Results. A total of 14 RCTs with 1593 participants were included in this SR. MA showed that acupuncture in combination with conventional medicine (CM) did not show statistical differences in reduction in pain. However, acupuncture in combination with CM significantly reduced the incidence of postoperative nausea and vomiting (PONV) (RR, 0.71; 95% CI, 0.55–0.92) and improved gastrointestinal function recovery compared to the CM group. Acupuncture combined with traditional Chinese medicine and CM, and acupuncture as monotherapy may improve gastrointestinal function recovery with acceptable adverse events. Conclusion. Acupuncture may be an effective and safe treatment for PCS. However, this study lacks conclusive evidence due to poor quality evidence, limited data, and clinical heterogeneity of acupuncture methods in the included studies.

The Clinical Observation on PONV with the Intervention of Thumbtack Needles Combined with Chinese Medicine Ironing Therapy

“…The treatment principle thus should be based on regulating the flow of breath power, harmonizing the stomach, and descending adversely risen stomach breath power to stop vomiting [ 18 ]. A growing body of evidence confirms the great potential of acupuncture for digestive motility, secretion, and absorption to improve the quality of postoperative analgesia, promote recovery of postoperative gastrointestinal function, and reduce the incidence of PONV [ 19 , 20 ]. Thumbtack needling therapy is a type of floating or shallow stabbing in traditional acupuncture to promote the circulation of breath power and blood in the meridian defence.…”

The Use of Evidence-Based Acupuncture: Current Evidence

“…A total of 1286 articles related to eight conditions were searched (Table 1). After reviewing the abstract and full text of the article, 17 systematic reviews and meta-analyses of the six conditions that met the inclusion criteria were finally included [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], and articles related to allergic rhinitis and chemotherapy-induced nausea and vomiting (CINV) did not meet the criteria for inclusion (Table 1).…”

“…Yin et al [27] found that acupuncture in combination with conventional treatment showed no statistical difference in pain reduction in Postcholecystectomy syndrome. The quality of the evidence for the overall outcomes was acceptable.…”

“…The results showed that there was 7.7% of outcomes with very low-quality evidence, 46.15% with low-quality evidence, 46.15% with moderate-quality evidence, and none with high-quality evidence. However, it is difficult for therapists and patients to use blinding for acupuncture [27]. Qin et al ( 2020) assessed the effectiveness of acupuncture and related techniques for postoperative pain after hemorrhoidectomy.…”

Acupuncture for biliary colic: a systematic review protocol

“… 15 20 So far, only one systematic review (SR) published in 2020 resulted that there is no statistical difference between acupuncture plus conventional medicine (CM) and single CM in reducing pain for patients with PCS. 21 In this case, a lack of SR to address the following pivotal questions: (1) is acupuncture effective in treating biliary colic with gallstones and (2) whether acupuncture an effective adjunctive therapy to CM for BC with gallstones. Thus, there is a chance for us to conceive a comprehensive review to determine the efficacy and safety of acupuncture for BC.…”