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Journal of Traditional Chinese Medicine >

2024 , Vol. 44 >Issue 1: 1 - 15

DOI: https://doi.org/10.19852/j.cnki.jtcm.20230904.003

Meta-Analyses

Efficacy of electroacupuncture on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and Meta-analysis

  • Xiaoyu QIN ,
  • Chunai WANG ,
  • Jianjun XUE ,
  • Jie ZHANG ,
  • Xiaoting LU ,
  • Shengshuang DING ,
  • Long GE ,
  • Minzhen WANG
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  • 1 the First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730030, China
    2 Department of Anesthesiology, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
    3 the First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730030, China; Department of Anesthesiology, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
    4 Evidence-based Medicine Center, Lanzhou University, Lanzhou 730030, China
    5 Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730030, China

Received date: 2022-11-12

  Accepted date: 2023-02-18

  Online published: 2023-09-04

Supported by

National Natural Science Foundation of China: Mechanism of Protective Effect of Acupoint Preconditioning on Myocardial Mitochondria and Energy Metabolism in Rats with Bupivacaine Toxicity(81760892)

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Abstract

OBJECTIVE: To evaluate the efficacy of electroacupuncture (EA) intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).

METHODS: Eight databases, including PubMed, Embase, the Cochrane Library, Web of Science, Chinese BioMedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Data, China Science and Technology Journal Database, and two clinical trial registries, were searched. All randomized controlled trials (RCTs) related to EA intervention in cardiac surgery with CPB were collected. Based on the inclusion and exclusion criteria, two researchers independently screened articles and extracted data. After the quality evaluation, RevMan 5.3 software was used for analysis.

RESULTS: Fourteen RCTs involving 836 patients were included. Compared with the control treatment, EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping [relative risk (RR) = 1.15, 95% confidence interval (CI) (1.01, 1.31), P < 0.05; moderate]. Twenty-four hours after aortic unclamping, EA significantly increased the superoxide dismutase [standardized mean difference (SMD) = 0.96, 95% CI(0.32, 1.61), P < 0.05; low], and interleukin (IL)-2 [SMD = 1.33, 95% CI(0.19, 2.47), P < 0.05; very low] expression levels and decreased the malondialdehyde [SMD =－1.62, 95% CI(－2.15, －1.09), P < 0.05; moderate], tumour necrosis factor-α [SMD = －1.28, 95% CI(－2.37, －0.19), P < 0.05; moderate], and cardiac troponin I [SMD = －1.09, 95% CI(－1.85, －0.32), P < 0.05; low] expression levels as well as the inotrope scores [SMD = －0.77, 95% CI(－1.22, －0.31), P < 0.05; high]. There was no difference in IL-6 and IL-10 expression levels. The amount of intraoperative sedative [SMD = -0.31, 95% CI(－0.54, －0.09), P < 0.05; moderate] and opioid analgesic [SMD = -0.96, 95% CI(－1.53, －0.38), P < 0.05; low] medication was significantly lower in the EA group than in the control group. Moreover, the postoperative tracheal intubation time [SMD = －0.92, 95% CI(－1.40, －0.45), P < 0.05; low] and intensive care unit stay [SMD = －1.71, 95% CI(－3.06, －0.36), P < 0.05; low] were significantly shorter in the EA group than in the control group. There were no differences in the time to get out of bed for the first time, total days of antibiotic use after surgery, or postoperative hospital stay. No adverse reactions related to EA were reported in any of the included studies.

CONCLUSIONS: In cardiac surgery with CPB, EA may be a safe and effective strategy to reduce myocardial ischaemia-reperfusion injury and speed up the recovery of patients after surgery. These findings must be interpreted with caution, as most of the evidence was of low or moderate quality. More RCTs with larger sample sizes and higher quality are needed to provide more convincing evidence.

Key words： electroacupuncture; cardiopulmonary bypass; thoracic surgery; myocardial ischaemia-reperfusion injury; myocardial protection; postoperative rehabilitation; Meta-analysis; randomized controlled trial

Cite this article

Xiaoyu QIN , Chunai WANG , Jianjun XUE , Jie ZHANG , Xiaoting LU , Shengshuang DING , Long GE , Minzhen WANG . Efficacy of electroacupuncture on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2024 , 44(1) : 1 -15 . DOI: 10.19852/j.cnki.jtcm.20230904.003

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