围手术期电针对患者术后β-内啡肽水平及疼痛影响的Meta分析

doi:10.16098/j.issn.0529-1356.2025.03.005

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解剖学报 ›› 2025, Vol. 56 ›› Issue (3) : 284-293. DOI: 10.16098/j.issn.0529-1356.2025.03.005

神经生物学

围手术期电针对患者术后β-内啡肽水平及疼痛影响的Meta分析

胡冉¹ 刘梓宸² 徐长依¹ 谢晨星¹吴辰³曹洋³ 刘帆^4* 张丽^5* 刘国凯^1*

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Effects of perioperative electroacupuncture on postoperative β-endorphin levels and pain in patients: a meta-analysis

HU Ran¹ LIU Zi-chen² XU Chang-yi¹ XIE Chen-xing¹ WU Chen³ CAO Yang³ LIU Fan^4* ZHANG Li^5* LIU Guo-kai^1*

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摘要

目的评估10项随机对照试验（RCT）中接受围手术期电针治疗的患者术后多时点血浆β-内啡肽（β-EP）、5-羟色胺（5-HT）和前列腺素E2(PGE2)水平的变化，并探讨电针对术后疼痛程度的治疗情况。方法使用特定关键字和术语的组合，在中国知网期刊全文数据库（CNKI）、万方学术期刊全文数据库（Wanfang）、重庆维普中文科技期刊数据库（VIP）、中国生物医学数据库（CBM）、Web of Science和PubMed进行搜索，检索自网站创立以来至2023年7月25日期间关于围手术期电针和βEP的随机对照试验（RCT）。观察围手术期进行电针治疗的患者相较于对照组术后12、24和48 h血浆β-EP含量的变化和疼痛视觉模拟评分（VAS）评分情况，术后24 h血浆-5-HT-和PGE2水平变化。使用RevMan 5.3统计学软件进行分析，R 4.3.1用来进行敏感性分析。结果最终纳入10篇RCTs，共计706名患者。与常规麻醉方式相比，电针联合常规麻醉能够明显提高患者血浆β-EP水平，术后12 h［SMD=2.79, 95% CI（1.85, 3.72）, Z =5.81, P<0.00001］；术后24 h ［SMD=1.87, 95% CI（0.9,2.83）, Z=3.79, P=0.0001］, 术后48 h ［SMD=2.02, 95% CI（1.49, 2.54）, Z=7.50, P<0.00001］。电针也促进患者术后24 h血浆PGE2和5-HT水平降低，改善术后12、24和48 h的VAS评分。结论围手术期电针能显著提高患者血浆β-EP水平，降低血浆致痛因子水平，是缓解术后急性疼痛的有效措施。

Abstract

Objective To evaluate the changes in postoperative plasma β-endorphin(β-EP) levels in patients who had received perioperative electroacupuncture（EA） treatment in 10 randomized controlled trials (RCTs) and examine the impact of EA on postoperative pain. Methods This meta-analysis evaluated the changes in plasma β-EP levels and visual analog scale (VAS) 12, 24 and 48 hours after surgery in patients receiving perioperative EA. It also assessed the changes in plasma serotonin (5-hydroxytryptamine, 5-HT) and prostaglandin E2 (PGE2) levels at 24 hours postsurgery. A comprehensive search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang, Chongqing VIP database, Chinese Biomedical Database (CBM), Web of Science, and PubMed databases. RCTs on perioperative EA and β-EP published from the inception of the websites up to July 25, 2023, were retrieved. Effect size aggregation, literature quality assessment, and bias analysis were performed using RevMan 5.3 software, and sensitivity analysis was conducted via R 4.3.1. Results A total of 10 RCTs involving 706 patients were included. EA in conjunction with conventional anesthesia significantly increased plasma β-EP levels at 12 hours postsurgery ［standard mean difference (SMD)=2.79, 95% CI (1.85, 3.72), Z=5.81, P<0.00001］, 24 hours postsurgery ［SMD=1.87, 95% CI (0.9, 2.83), Z=3.79, P=0.0001］, and 48 hours postsurgery ［SMD=2.02, 95% CI (1.49, 2.54), Z=7.50, P<0.00001］. EA reduced plasma PGE2 levels at 24 hours postsurgery and plasma 5-HT levels at 24 hours postsurgery, and the VAS at 12, 24 and 48 hours after surgery also decreased. Conclusion These findings suggest that perioperative EA markedly elevates plasma β-EP levels, reduces pain-inducing factors in plasma, and effectively alleviates acute postoperative pain.

关键词

围手术期电针

/ 术后疼痛 / β-内啡肽 / 5-羟色胺 / 前列腺素E2 / 人

Key words

Perioperative electroacupuncture

/ Postoperative pain / β-endorphin / 5-Hydroxytryptamine / Prostaglandin E2 / Human

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胡冉刘梓宸徐长依谢晨星吴辰曹洋刘帆张丽刘国凯. 围手术期电针对患者术后β-内啡肽水平及疼痛影响的Meta分析[J]. 解剖学报. 2025, 56(3): 284-293 https://doi.org/10.16098/j.issn.0529-1356.2025.03.005

HU Ran LIU Zi-chen XU Chang-yi XIE Chen-xing WU Chen CAO Yang LIU Fan ZHANG Li LIU Guo-kai. Effects of perioperative electroacupuncture on postoperative β-endorphin levels and pain in patients: a meta-analysis[J]. Acta Anatomica Sinica. 2025, 56(3): 284-293 https://doi.org/10.16098/j.issn.0529-1356.2025.03.005

中图分类号： R363 R245

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