探討耳穴貼壓對痛經之效應：系統性回顧暨統合分析

背景：痛經好發於年輕女性，可能在經期前、中或結束後出現下腹疼痛感，抑或伴隨其他身體不適之情形，甚至產生心理情緒之改變。目的：藉由系統性文獻回顧暨統合分析，分析耳穴貼壓對痛經之改善成效。方法：以原發性痛經、經痛、耳穴、耳穴貼壓等關鍵字，搜尋2004年1月至2018年12月發表於PubMed、CINAHL、Cochrane Library、EMBASE、ScienceDirect、CEPS、中國期刊全文數據庫、台灣期刊論文索引系統及台灣博碩士論文資訊網等之實驗性研究文獻。根據本研究納入及排除條件，納入15篇研究進行系統性文獻回顧，主要評估指標包含疼痛視覺類比量表（VASP）、簡明式麥基爾疼痛量表（SF-MPQ）以及經期生理不適量表（SF-MDQ）。結果：共12篇文獻進入統合分析，耳穴貼壓對痛經之改善成效，其綜合效果量在疼痛視覺類比量表為-0.785（9篇，95% CI=[-1.114,-0.456]）、簡明式麥基爾疼痛量表-0.317（3篇，95% CI=[-0.556, -0.078]）及經期不適-0.540（6篇，95% CI=[-0.722, -0.358]）。結論：本研究結果發現耳穴貼壓對痛經有改善成效，並歸納可選取子宮、內分泌、交感、神門、腎、肝、皮質下等耳穴點，此結果不僅可作為爾後執行之參考，亦能提供客觀的實證知識與訊息，作為醫護專業者改善痛經之參酌。

關鍵字

耳穴；痛經；系統性文獻回顧；統合分析

並列摘要

Background: Dysmenorrhea occurs in young women who present to lower abdomen pain just before and or during menstruation. That may be combined other physical discomforts, or psychological emotions stressors. 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 auriculotherapy for dysmenorrhea. Methods: Searches were conducted in databases including PerioPath Index to Taiwan Periodical Literature System, National Digital Library of Theses and Dissertations in Taiwan, CEPS, CJFD, Wanfang data, CINAHL Plus with Full Text, Cochrane Library, EMBASE.com, PubMed Central, and ScienceDirect. The keywords were conducted by dysmenorrhea, menstrual pain, primary dysmenorrheal; ear acupressure, auricular point acupressure, auricular acupressure, auricular point sticking, ear acupuncture, auricular acupuncture, ear acupoint, auricular acupoint, acupuncture with electric stimulation, auriculotherapy etc. The search focused on articles published between Jun 2004and Dec 2018. Based on inclusion and exclusion criteria, 15 articles addressing relevant experimental research design was extracted. The main outcomes assessed were VASP, SF-MPQ and SF-MDQ scale. Results: The 12 studies showed that the auriculotherapy intervention had significant effects on pain relief, with respective effect sizes of -0.785 (9studies, 95% CI=[-1.114, -0.456]), -0.317 (3 studies, 95% CI= [-0.556, -0.078]), and -0.540(6 studies, 95% CI= [-0.722, -0.358]). Conclusion: The result of this study not only indicates that auriculotherapy may improve dysmenorrhea, but also summary the main acupoints such as uterus, endocrine, sympathetic, shen-men, kidney, liver, and subcortical etc. Further study is needed to help health care staffs' better advice patients on the effects of auriculotherapy for dysmenorrhea.

並列關鍵字

auriculotherapy ； dysmenorrhea ； systemic review ； meta-analysis

參考文獻

Nordmann, A.J., B. Kasenda, and M. Briel, Metaanalyses: what they can and cannot do.Swiss Med. Wkly.2012;142:w13518.

Google Scholar

Egger, M., G.D. Smith, M. Schneider, and C. Minder, Bias in meta-analysis detected by a simple, graphical test. BMJ.1997;315:629-634.

Google Scholar

Egger, M., G.D. Smith, and A.N. Phillips, Metaanalysis: Principles and procedures.BMJ.1997; 315:1533-1537.

Google Scholar

Higgins J.P.T., Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.Available from http:www.cochrane-handbook.org.