Efficacy and safety of acupuncture on sepsis: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Yidan , XU Min , WANG Rui , XU Mingzhe ,  YANG Jing ,  LIU Jin

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

YANG Jing, Email: hxyangjing@qq.com; LIU Jin, Email: scujinliu@gmail.com

Keywords：

Acupuncture; Sepsis; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.201910006

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematic review the efficacy and safety of acupuncture on patients with sepsis.Methods The PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were searched. The retrieval time was from the inception to October 1^st, 2019. The randomized controlled trials (RCTs) about acupuncture on the sepsis were screened. Two researchers independently screened the articles, extracted and analyzed the data, evaluated the risk of bias included in the study. Meta-analysis was performed by RevMan 5.3 software.Results A total of 20 RCTs involving 1 337 patients were included. Meta-analysis showed that there were significant differences between the acupuncture group with conventional treatment in 28-day mortality [RR=0.69, 95%CI (0.5, 0.9), P=0.03], APACHE II score at 3^rd day [MD=−2.4, 95%CI (−3.68, −1.12), P=0.0002] and 7^th day [MD=−4.37, 95%CI (−6.32, −2.21), P<0.0001], length of the ICU stay [MD=−1.54, 95%CI (−2.81, −0.27), P=0.02], the effective rate for improved gastrointestinal function [RR=1.5, 95%CI (1.09, 2.06), P=0.01], concentrations of PCT [MD=−2.23, 95%CI (−3.33, −1.13), P<0.001] and TNF-α [MD=-14.86, 95%CI (−23.74, −5.97), P=0.001] at 7^th day. However, there was no significant difference between the two groups about the CD8+ count at 7^th day [MD=1.65, 95%CI (−0.32, 3.62), P=0.1].Conclusion Available evidence suggests that acupuncture may be a potential treatment method for sepsis patients. Due to the limited quantity and quality of included studios, the above conclusions are needed to be verified by more high-quality studies.

Citation： TANG Yidan, XU Min, WANG Rui, XU Mingzhe, YANG Jing, LIU Jin. Efficacy and safety of acupuncture on sepsis: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(2): 174-180. doi: 10.7507/1672-2531.201910006 Copy

1.	Cavaillon JM. Polymyxin B for endotoxin removal in sepsis. Lancet Infect Dis, 2011, 11(6): 426-427.
2.	梁群, 王丛, 王若晖, 等. 中西医结合治疗脓毒症的临床疗效观察. 中国急救医学, 2014, 34(10): 886-888.
3.	郭键, 贾济, 陈绍洋, 等. 针刺抗炎研究进展. 国际麻醉学与复苏学, 2015, 36(6): 569-572.
4.	吴凡伟, 周仙仕, 叶烨, 等. 针刺治疗脓毒症机理研究进展. 国际中医中药杂志, 2016, 38(11): 1046-1049.
5.	李海峰, 胡国强, 刘雯雯. 针刺华佗夹脊穴治疗脓毒血症胃肠功能障碍临床疗效观察. 针刺研究, 2019, 44(1): 43-46.
6.	吴建浓, 伍万, 朱美飞, 等. 电针治疗对脓毒症患者的免疫功能的影响. 浙江中医药大学学报, 2013, (6): 768-770.
7.	吴建浓, 朱美飞, 雷澍, 等. 电针对脓毒症患者肠道通透性的影响. 中国针灸, 2013, 33(3): 203-206.
8.	王丽娟, 李健, 李小娟. 针刺疗法治疗脓毒症临床疗效和安全性的Meta分析. 中医药导报, 2018, 24(23): 90-94.
9.	李莉, 穆蕊, 余剑波, 等. 电针足三里穴和尺泽穴对脓毒症患者急性肺损伤的影响. 中华麻醉学杂志, 2013, 33(5): 626-629.
10.	杨广, 胡瑞英, 陈明, 等. 电针足三里、关元穴对脓毒症患者炎症反应的影响. 广州中医药大学学报, 2015, 32(3): 430-433.
11.	Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med, 2003, 31(4): 1250-1256.
12.	Yang G, Hu RY, Deng AJ, et al. Effects of electro-acupuncture at zusanli, guanyuan for sepsis patients and its mechanism through immune regulation. Chin J Integr Med, 2016, 22(3): 219-224.
13.	金水芳, 虞玉群, 江荣林. 电针对脓毒症患者炎症细胞因子的影响. 浙江中西医结合杂志, 2016, 26(2): 136-137.
14.	虞意华, 金肖青, 俞迈红, 等. 针灸对老年严重脓毒症患者胃肠功能及胃肠激素影响的临床研究. 中华中医药学刊, 2015, 33(8): 1953-1956.
15.	钟建华, 张朝晖, 瞿星光, 等. 针刺足三里及合谷穴辅助治疗脓毒症临床效果观察. 中国急救医学, 2015, 35(12): 1072-1074.
16.	中华医学会重症医学分会. 成人严重感染与感染性休克血流动力学监测与支持指南(2006). 中国实用外科杂志, 2007, 1(33): 5-7.
17.	蔡莉娟, 丁学军, 刘文兵, 等. 电针对脓毒症患者胃肠功能障碍的干预作用. 中国中医急症, 2014, 23(2): 268-270.
18.	吴凡伟. 电针刺激足三里穴对脓毒证患者炎症反应和免疫功能的影响. 中国中医急症, 2016, 25(9): 1794-1797.
19.	肖秋生, 马明远, 张兴胜, 等. 针刺对脓毒症患者免疫功能及预后的影响. 中国中西医结合杂志, 2015, 35(7): 783-786.
20.	Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med, 2013, 39(2): 165-228.
21.	方军, 李兰, 李冰冰, 等. 针灸对严重脓毒症患者胃肠功能障碍及胃肠激素影响分析. 湖南中医药大学学报, 2016, 36(6): 11.
22.	曾维忠, 吴双华, 罗勇, 等. 针刺对感染性休克患者T细胞亚群及PCT水平的影响. 上海针灸杂志, 2016, 35(8): 909-912.
23.	王婷, 曾维忠, 刘德凯, 等. 针刺足三里、关元穴对感染性休克患者疗效和血清降钙素原水平的影响. 针灸临床杂志, 2016, 32(3): 18-20.
24.	曾维忠, 吴双华, 袁光辉, 等. 扶阳救逆针刺法对感染性休克患者T细胞亚群的影响. 中国中医急症, 2017, 26(5): 851-853.
25.	金友平, 江丽平, 郭净, 等. 针灸对感染性休克患者CD4+CD25+调节性T细胞及Foxp3的影响. 中国基层医药, 2017, 24(18): 2784-2787.
26.	林兵, 吴伟, 张伟清, 等. 针刺患者足三里、关元穴对感染性休克的治疗效果研究. 中华医院感染学杂志, 2017, 27(4): 766-769.
27.	胡瑞英, 杨广, 李健, 等. 电针治疗脓毒症肠功能障碍的临床研究. 辽宁中医杂志, 2015, 42(11): 2195-2196.
28.	中国中西医结合学会急救医学专业委员会. 脓毒症中西医结合诊治专家共识. 中华危重病急救医学, 2013, 25(4): 194-197.
29.	卓剑丰, 李健. 针灸对老年严重脓毒症患者胃肠功能的影响. 山西中医, 2017, 33(5): 30-30.
30.	Meng JB, Jiao YN, Xu XJ, et al. Electro-acupuncture attenuates inflammatory responses and intraabdominal pressure in septic patients: A randomized controlled trial. Medicine (Baltimore), 2018, 97(17): e0555.
31.	Meng JB, Jiao YN, Zhang G, et al. Electro acupuncture improves intestinal dysfunction in septic patients: a randomised controlled trial. Biomed Res Int, 2018, 2018: 8293594.
32.	曾一千, 曾维忠, 彭苏娜, 等. 针刺治疗脓毒症急性肾损伤临床疗效分析. 中国医师杂志, 2018, 20(11): 1684-1686.
33.	Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update. Crit Care Med, 2018, 46(6): 997-1000.
34.	Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
35.	叶华清, 兰超. 降钙素原与APACHEⅡ评分对脓毒症严重程度及预后的评估价值. 河南外科学杂志, 2019, 25(2): 29-31.
36.	Puleo F, Arvanitakis M, Van Gossum A, et al. Gut failure in the ICU. Semin Respir Crit Care Med, 2011, 32(5): 626-638.
37.	Howell MD, Davis AM. Management of sepsis and septic shock. JAMA, 2017, 317(8): 847-848.
38.	Reintam Blaser A, Poeze M, Malbrain ML, et al. Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study. Intensive Care Med, 2013, 39(5): 899-909.
39.	焦明远, 马俊凤, 李彤. PCT, NT-pro BNP在脓毒症患者预后评估中的价值及与APACHE Ⅱ评分的关系. 湖南师范大学学报(医学版), 2019, 16(4): 179-182.
40.	李爱林, 袁鼎山. 脓毒症患者血清CRP, sTREM-1和PCT水平变化及其临床意义研究. 东南大学学报(医学版), 2018, 37(4): 729-733.
41.	王晓燕, 张流忠, 周莉, 等. 脓毒症患者血清CRP, TNF-α水平变化及意义. 山东医药, 2012, 52(34): 34-35.
42.	戴凌燕, 章义利, 程碧环. T淋巴细胞亚群变化与脓毒症发病的关系. 中华全科医学, 2014, 12(5): 715-716.

1. Cavaillon JM. Polymyxin B for endotoxin removal in sepsis. Lancet Infect Dis, 2011, 11(6): 426-427.
2. 梁群, 王丛, 王若晖, 等. 中西医结合治疗脓毒症的临床疗效观察. 中国急救医学, 2014, 34(10): 886-888.
3. 郭键, 贾济, 陈绍洋, 等. 针刺抗炎研究进展. 国际麻醉学与复苏学, 2015, 36(6): 569-572.
4. 吴凡伟, 周仙仕, 叶烨, 等. 针刺治疗脓毒症机理研究进展. 国际中医中药杂志, 2016, 38(11): 1046-1049.
5. 李海峰, 胡国强, 刘雯雯. 针刺华佗夹脊穴治疗脓毒血症胃肠功能障碍临床疗效观察. 针刺研究, 2019, 44(1): 43-46.
6. 吴建浓, 伍万, 朱美飞, 等. 电针治疗对脓毒症患者的免疫功能的影响. 浙江中医药大学学报, 2013, (6): 768-770.
7. 吴建浓, 朱美飞, 雷澍, 等. 电针对脓毒症患者肠道通透性的影响. 中国针灸, 2013, 33(3): 203-206.
8. 王丽娟, 李健, 李小娟. 针刺疗法治疗脓毒症临床疗效和安全性的Meta分析. 中医药导报, 2018, 24(23): 90-94.
9. 李莉, 穆蕊, 余剑波, 等. 电针足三里穴和尺泽穴对脓毒症患者急性肺损伤的影响. 中华麻醉学杂志, 2013, 33(5): 626-629.
10. 杨广, 胡瑞英, 陈明, 等. 电针足三里、关元穴对脓毒症患者炎症反应的影响. 广州中医药大学学报, 2015, 32(3): 430-433.
11. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med, 2003, 31(4): 1250-1256.
12. Yang G, Hu RY, Deng AJ, et al. Effects of electro-acupuncture at zusanli, guanyuan for sepsis patients and its mechanism through immune regulation. Chin J Integr Med, 2016, 22(3): 219-224.
13. 金水芳, 虞玉群, 江荣林. 电针对脓毒症患者炎症细胞因子的影响. 浙江中西医结合杂志, 2016, 26(2): 136-137.
14. 虞意华, 金肖青, 俞迈红, 等. 针灸对老年严重脓毒症患者胃肠功能及胃肠激素影响的临床研究. 中华中医药学刊, 2015, 33(8): 1953-1956.
15. 钟建华, 张朝晖, 瞿星光, 等. 针刺足三里及合谷穴辅助治疗脓毒症临床效果观察. 中国急救医学, 2015, 35(12): 1072-1074.
16. 中华医学会重症医学分会. 成人严重感染与感染性休克血流动力学监测与支持指南(2006). 中国实用外科杂志, 2007, 1(33): 5-7.
17. 蔡莉娟, 丁学军, 刘文兵, 等. 电针对脓毒症患者胃肠功能障碍的干预作用. 中国中医急症, 2014, 23(2): 268-270.
18. 吴凡伟. 电针刺激足三里穴对脓毒证患者炎症反应和免疫功能的影响. 中国中医急症, 2016, 25(9): 1794-1797.
19. 肖秋生, 马明远, 张兴胜, 等. 针刺对脓毒症患者免疫功能及预后的影响. 中国中西医结合杂志, 2015, 35(7): 783-786.
20. Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med, 2013, 39(2): 165-228.
21. 方军, 李兰, 李冰冰, 等. 针灸对严重脓毒症患者胃肠功能障碍及胃肠激素影响分析. 湖南中医药大学学报, 2016, 36(6): 11.
22. 曾维忠, 吴双华, 罗勇, 等. 针刺对感染性休克患者T细胞亚群及PCT水平的影响. 上海针灸杂志, 2016, 35(8): 909-912.
23. 王婷, 曾维忠, 刘德凯, 等. 针刺足三里、关元穴对感染性休克患者疗效和血清降钙素原水平的影响. 针灸临床杂志, 2016, 32(3): 18-20.
24. 曾维忠, 吴双华, 袁光辉, 等. 扶阳救逆针刺法对感染性休克患者T细胞亚群的影响. 中国中医急症, 2017, 26(5): 851-853.
25. 金友平, 江丽平, 郭净, 等. 针灸对感染性休克患者CD4+CD25+调节性T细胞及Foxp3的影响. 中国基层医药, 2017, 24(18): 2784-2787.
26. 林兵, 吴伟, 张伟清, 等. 针刺患者足三里、关元穴对感染性休克的治疗效果研究. 中华医院感染学杂志, 2017, 27(4): 766-769.
27. 胡瑞英, 杨广, 李健, 等. 电针治疗脓毒症肠功能障碍的临床研究. 辽宁中医杂志, 2015, 42(11): 2195-2196.
28. 中国中西医结合学会急救医学专业委员会. 脓毒症中西医结合诊治专家共识. 中华危重病急救医学, 2013, 25(4): 194-197.
29. 卓剑丰, 李健. 针灸对老年严重脓毒症患者胃肠功能的影响. 山西中医, 2017, 33(5): 30-30.
30. Meng JB, Jiao YN, Xu XJ, et al. Electro-acupuncture attenuates inflammatory responses and intraabdominal pressure in septic patients: A randomized controlled trial. Medicine (Baltimore), 2018, 97(17): e0555.
31. Meng JB, Jiao YN, Zhang G, et al. Electro acupuncture improves intestinal dysfunction in septic patients: a randomised controlled trial. Biomed Res Int, 2018, 2018: 8293594.
32. 曾一千, 曾维忠, 彭苏娜, 等. 针刺治疗脓毒症急性肾损伤临床疗效分析. 中国医师杂志, 2018, 20(11): 1684-1686.
33. Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update. Crit Care Med, 2018, 46(6): 997-1000.
34. Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
35. 叶华清, 兰超. 降钙素原与APACHEⅡ评分对脓毒症严重程度及预后的评估价值. 河南外科学杂志, 2019, 25(2): 29-31.
36. Puleo F, Arvanitakis M, Van Gossum A, et al. Gut failure in the ICU. Semin Respir Crit Care Med, 2011, 32(5): 626-638.
37. Howell MD, Davis AM. Management of sepsis and septic shock. JAMA, 2017, 317(8): 847-848.
38. Reintam Blaser A, Poeze M, Malbrain ML, et al. Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study. Intensive Care Med, 2013, 39(5): 899-909.
39. 焦明远, 马俊凤, 李彤. PCT, NT-pro BNP在脓毒症患者预后评估中的价值及与APACHE Ⅱ评分的关系. 湖南师范大学学报(医学版), 2019, 16(4): 179-182.
40. 李爱林, 袁鼎山. 脓毒症患者血清CRP, sTREM-1和PCT水平变化及其临床意义研究. 东南大学学报(医学版), 2018, 37(4): 729-733.
41. 王晓燕, 张流忠, 周莉, 等. 脓毒症患者血清CRP, TNF-α水平变化及意义. 山东医药, 2012, 52(34): 34-35.
42. 戴凌燕, 章义利, 程碧环. T淋巴细胞亚群变化与脓毒症发病的关系. 中华全科医学, 2014, 12(5): 715-716.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of acupuncture on sepsis: a systematic review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content