Effects of moxibustion on gastrointestinal function recovery in preventing early postoperative small-bowel obstruction: a meta-analysis.

Abstract

Moxibustion is widely used in the recovery of gastrointestinal function in East Asian countries, especially in China. This systematic review aims to evaluate the recovery effects of moxibustion on gastrointestinal function in preventing early postoperative small-bowel obstruction (EPSBO). The Medline, Embase, PubMed, and the other seven databases were searched independently by two authors. Randomized controlled trials (RCTs) were selected using the PICOS method. The methodological quality was appraised with the Cochrane's risk of bias tool, and the reporting quality of included studies was evaluated by Consolidated Standards of Reporting Trials (CONSORT) and STandards for Reporting Interventions in Clinical Trials of Moxibustion (STRICTOM), respectively. Revman 5.2.0 was used for statistical analysis, and the mean difference (MD) with 95% confidence interval (CI) was performed for effect estimation. Random effects model (REM) and fixed effects model (FEM) were used for pooling data. A total of 8 RCTs with 693 participants were included. Meta-analysis showed that moxibustion combined with usual care had favorable effects on the time to first flatus (MD -15.15 h, 95% CI: -19.14 to -11.15, 8 studies, I2=85%, P<0.00001, REM), the time to bowel sound recovery (MD -10.35 h, 95% CI: -11.65 to -9.06, 7 studies, I2=0%, P=0.91, FEM), the time to first defecation (MD -18.94 h, 95% CI: -24.53 to -13.36, 3 studies, I2=45%, P=0.16, FEM), and the duration time to abdominal distention (MD -11.7 h, 95% CI: -15.32 to -8.09, 3 studies, I2=0%, P=0.70, FEM) when compared to the controls. No adverse events were reported in the included studies. Moxibustion may have a beneficial effect on the recovery of gastrointestinal function in preventing EPSBO. However, positive findings should be treated carefully. And rigorous studies with high quality and large samples are warranted.