Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis

ObjectivesThis study aimed to evaluate and compare the efficacy and safety of different acupuncture and moxibustion techniques as adjunctive therapy in addressing Postoperative gastrointestinal dysfunction (PGD) associated with gastric cancer (GC).MethodsEight medical databases were comprehensively...

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Main Authors: Yangxu Ou, Dezhi Lin, Xixiu Ni, Chengzhi Feng, Jing Rong, Xiaoyu Gao, Yang Yu, Xinrui Liu, Zhiyang Zhang, Wang Xiao, Zili Tang, Ling Zhao
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1464749/full
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author Yangxu Ou
Dezhi Lin
Xixiu Ni
Chengzhi Feng
Jing Rong
Xiaoyu Gao
Yang Yu
Xinrui Liu
Zhiyang Zhang
Wang Xiao
Wang Xiao
Zili Tang
Ling Zhao
Ling Zhao
Ling Zhao
author_facet Yangxu Ou
Dezhi Lin
Xixiu Ni
Chengzhi Feng
Jing Rong
Xiaoyu Gao
Yang Yu
Xinrui Liu
Zhiyang Zhang
Wang Xiao
Wang Xiao
Zili Tang
Ling Zhao
Ling Zhao
Ling Zhao
author_sort Yangxu Ou
collection DOAJ
description ObjectivesThis study aimed to evaluate and compare the efficacy and safety of different acupuncture and moxibustion techniques as adjunctive therapy in addressing Postoperative gastrointestinal dysfunction (PGD) associated with gastric cancer (GC).MethodsEight medical databases were comprehensively searched for relevant randomized controlled trials (RCTs) as of October 2024. A network meta-analysis (NMA) was performed using frequency models, combining all available direct and indirect evidence from RCTs. Time of first bowel sounds (TFBS) was set as the primary outcome, and time to first defecation (TFD) and time to first flatus (TFF) were set as the secondary outcomes. All outcomes were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of treatments, and the probability that the intervention will be in one of the top ranks increases with a higher SUCRA value.ResultsWith 28 randomized controlled trials (RCTs) and 2,459 patients, 18 of which involved adjuvant acupuncture treatments. NMA based on SUCRA rankings showed that routine care (RC) with acupuncture (ACU), with acupressure (ACUP), with moxibustion (MOX) and acupoint injection (AI) were the top-ranked therapies for shortening TFBS and TFF in patients with GC compared with RC; additionally, RC + MOX + CUP and RC + MOX were the relatively best therapies for TFD. No serious adverse events were reported in the studies assessing the safety of adjunctive acupuncture therapy. Our study found that ST36, ST37, ST39, and PC6 were the most commonly used acupoints for adjuvant acupuncture treatments in treating PGD associated with GC.ConclusionAcupuncture and moxibustion, when used as supplementary therapies, demonstrated efficacy and relative safety in managing PGD associated with GC. The recommended order for adjunctive acupuncture- and moxibustion-related therapies for PGD in patients with GC, in terms of conservativeness, is as follows: RC + ACU, RC + MOX + AI, RC + ACUP, RC + MOX + CUP and RC + MOX. Despite their inclusion, the overall methodological quality of the studies was poor, which need for further high-quality randomized controlled trials to support existing results.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO.
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spelling doaj-art-6f4a0372cca24dbbbe47ca02ea64ee122025-08-20T01:54:57ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-12-011110.3389/fmed.2024.14647491464749Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysisYangxu Ou0Dezhi Lin1Xixiu Ni2Chengzhi Feng3Jing Rong4Xiaoyu Gao5Yang Yu6Xinrui Liu7Zhiyang Zhang8Wang Xiao9Wang Xiao10Zili Tang11Ling Zhao12Ling Zhao13Ling Zhao14Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaHospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaSichuan Clinical Medical Research Centre for Acupuncture and Moxibustion, Chengdu, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaAcupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, ChinaSichuan Clinical Medical Research Centre for Acupuncture and Moxibustion, Chengdu, ChinaKey Laboratory of Acupuncture for Senile Disease, Chengdu University of TCM, Ministry of Education, Chengdu, ChinaObjectivesThis study aimed to evaluate and compare the efficacy and safety of different acupuncture and moxibustion techniques as adjunctive therapy in addressing Postoperative gastrointestinal dysfunction (PGD) associated with gastric cancer (GC).MethodsEight medical databases were comprehensively searched for relevant randomized controlled trials (RCTs) as of October 2024. A network meta-analysis (NMA) was performed using frequency models, combining all available direct and indirect evidence from RCTs. Time of first bowel sounds (TFBS) was set as the primary outcome, and time to first defecation (TFD) and time to first flatus (TFF) were set as the secondary outcomes. All outcomes were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of treatments, and the probability that the intervention will be in one of the top ranks increases with a higher SUCRA value.ResultsWith 28 randomized controlled trials (RCTs) and 2,459 patients, 18 of which involved adjuvant acupuncture treatments. NMA based on SUCRA rankings showed that routine care (RC) with acupuncture (ACU), with acupressure (ACUP), with moxibustion (MOX) and acupoint injection (AI) were the top-ranked therapies for shortening TFBS and TFF in patients with GC compared with RC; additionally, RC + MOX + CUP and RC + MOX were the relatively best therapies for TFD. No serious adverse events were reported in the studies assessing the safety of adjunctive acupuncture therapy. Our study found that ST36, ST37, ST39, and PC6 were the most commonly used acupoints for adjuvant acupuncture treatments in treating PGD associated with GC.ConclusionAcupuncture and moxibustion, when used as supplementary therapies, demonstrated efficacy and relative safety in managing PGD associated with GC. The recommended order for adjunctive acupuncture- and moxibustion-related therapies for PGD in patients with GC, in terms of conservativeness, is as follows: RC + ACU, RC + MOX + AI, RC + ACUP, RC + MOX + CUP and RC + MOX. Despite their inclusion, the overall methodological quality of the studies was poor, which need for further high-quality randomized controlled trials to support existing results.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO.https://www.frontiersin.org/articles/10.3389/fmed.2024.1464749/fullpostoperative gastrointestinal dysfunctionnetwork meta-analysissystematic reviewacupuncturemoxibustiontime of first bowel sounds
spellingShingle Yangxu Ou
Dezhi Lin
Xixiu Ni
Chengzhi Feng
Jing Rong
Xiaoyu Gao
Yang Yu
Xinrui Liu
Zhiyang Zhang
Wang Xiao
Wang Xiao
Zili Tang
Ling Zhao
Ling Zhao
Ling Zhao
Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis
Frontiers in Medicine
postoperative gastrointestinal dysfunction
network meta-analysis
systematic review
acupuncture
moxibustion
time of first bowel sounds
title Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis
title_full Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis
title_fullStr Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis
title_full_unstemmed Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis
title_short Acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer: a systematic review and network meta-analysis
title_sort acupuncture and moxibustion as adjunctive therapy for postoperative gastrointestinal dysfunction in gastric cancer a systematic review and network meta analysis
topic postoperative gastrointestinal dysfunction
network meta-analysis
systematic review
acupuncture
moxibustion
time of first bowel sounds
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1464749/full
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