火針對治療壓傷患者的效益：系統性回顧與統合分析

The Efficacy of Fire Needle in Managing Patients With Pressure Injury: A Systematic Review and Meta-Analysis

張尚智(Shang-Chih Chang) ； 張馨予(Hsin-Yu Chang)

《中華針灸醫學會雜誌》 24卷1-2期 (2021/06) Pp. 1-11

摘要

目的：探討火針介入治療時對於壓傷患者瘡口治療效果。方法：英文文獻以「Pressure sore」、「Pressure ulcer」、「Pressure injury」、「Bedsore」或「Ulcer」與「Fire needle」、「Acupuncture」作關鍵字聯集，搜尋「Pubmed」、「Cochrane library」等查詢系統；中文文獻以篇名「壓瘡」、「褥瘡」、「壓傷」與全文含「火針」作聯集，搜尋「PubMed」、「Cochrane Library」、「Google scholar」、「華藝線上圖書館」、「中國知網」、「萬方數據庫」之2020年12月以前的隨機臨床試驗（randomized controlled trial, RCT）相關文獻。結果：共得5篇隨機臨床試驗（RCT）相關文獻，統合分析火針介入合併傷口照護對壓傷瘡口之改善成效，綜合效果量為5.06（95% CI=[2.02, 12.67], p =0.0005），而與一般傷口照護組比較為6.46（4篇，95% CI=[1.66, 25.13], p =0.007）及與傷口照護合併針刺治療比較為3.64（1篇，95% CI=[1.38, 9.63], p=0.009）。結論：火針對於壓傷治療有改善成效，但臨床試驗仍存在若干問題：如納入與排除標準未明確，對照組的設計不一，評估標準未能統一及客觀評分⋯等。若能解決這些問題，更能證實火針在壓傷瘡口上的療效，進而提供客觀的實證知識與訊息，作為醫護專業者改善壓傷之參酌。

關鍵字

壓傷 ； 褥瘡 ； 系統性回顧 ； 火針 ； 針灸

並列摘要

Purpose: The aims of this study was to conduct a systematic review and meta-analysis that uses published experimental research design to analyze the effect of Fire Needle for pressure injury. Methods: Searches were conducted in databases including PubMed, Cochrane Library, Google scholar, Airiti library, Wanfang data and China National Knowledge Infrastructure (CNKI). The keywords were conducted by pressure injury, bedsore, ulcer; fire needle, acupuncture etc. The search focused on articles published before Dec 2020. Based on inclusion and exclusion criteria, 5 articles addressing relevant experimental research design was extracted. Results: The 5 studies showed that the fire needle intervention had significant effects on wound healing , with respective effect sizes of 5.06 (5 studies 95% CI= [ 2.02, 12.67], p =0.0005), 6.4 (4 studies, 95% CI=[1.66, 25.13] p =0.007), 3.64 (1 study, 95% CI=[1.38, 9.63] p=0.009). Conclusion: Fire needle has improved effectiveness on the pressure injury, but there are still several problems in clinical trials. Such as the unclear inclusion and exclusion criteria, the different design of the control group, the failure of uniform evaluation criteria and objective scores... etc. If these problems can be solved, it will be able to prove the efficacy of fire needle on pressure injury, and then provide objective empirical knowledge and information as a reference for medical professionals to imp rove pressure injury.

並列關鍵字

Pressure injury ； Bedsore ； Systematical reviews ； Fire needle ； Acupuncture

參考文獻

Norton L, Parslow N, Johnston D, Ho C, Afalavi A, Mark M, Moffat S: Best practice recommendations for the prevention and management of pressure injuries. Wounds Canada 2017.

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