针灸已被证明对接受增强恢复术后（ERAS）协议的肿瘤患者恢复胃肠功能有效。本系统综述和荟萃分析的目的是评估将针灸纳入ERAS策略以恢复胃肠功能的合理性和有效性。我们搜索了11个数据库，寻找与ERAS协议治疗下肿瘤患者胃肠功能障碍的针灸随机临床试验（RCT）。根据Cochrane合作风险偏倚评估和修改后的Jadad量表，评估了每篇文章的质量。作为独立症状，主要结局是术后口服摄入时间、首次排气时间、首次通便时间和蠕动声恢复时间（PSRT）。还研究了疼痛控制、不良事件和纳入研究中报告的穴位名称。在211篇回顾摘要中，有9项研究（702名患者）符合纳入标准，并被纳入本系统综述和荟萃分析。与对照组相比，针灸组在术后口服摄入时间（标准化均值差=-0.77，95%置信区间（CI）=-1.18 to -0.35）、首次排气时间（标准化均值差=-0.81，95% CI=-1.13 to -0.48）、首次排便时间（标准化均值差=-0.91，95% CI=-1.41 to -0.41）、PSRT（标准化均值差=-0.92，95% CI=-1.93 to 0.08）和疼痛强度（标准化均值差=-0.60，95% CI=-0.83 to -0.37）方面显示出显著减少。在包含的9项研究中，足三里（ST36）和上巨虚（ST37）穴位被用于其中八项。两项研究观察到与针灸相关的不良事件，并且仅报告了一例瘀伤。本系统综述和荟萃分析表明，与对照组相比，针灸显著改善了肿瘤患者接受ERAS协议后的胃肠功能恢复和疼痛控制。此外，ST36和ST37是最常用的穴位。虽然包含的研究中关于针灸的安全性描述较少，但现有数据表明，针灸是一种安全的治疗方法，仅有轻微副作用。这些发现为将针灸纳入肿瘤患者的ERAS协议提供了基于证据的建议。 https://www.crd.york.ac.uk/prospero/ PROSPERO，标识符CRD42023430211。版权所有 © 2023 Chen, Fu, Liu, Xie和Li.

Acupuncture has been shown to be effective in restoring gastrointestinal function in tumor patients receiving the enhanced recovery after surgery (ERAS) protocol. The present systematic review and meta-analysis aimed to evaluate the rationality and efficacy of integrating acupuncture in the ERAS strategy to recuperate gastrointestinal function.We searched eleven databases for relevant randomized clinical trials (RCTs) of acupuncture for the treatment of gastrointestinal dysfunction in tumor patients treated with the ERAS protocol. The quality of each article was assessed using the Cochrane Collaboration risk of bias criteria and the modified Jadad Scale. As individual symptoms, the primary outcomes were time to postoperative oral food intake, time to first flatus, time to first distension and peristaltic sound recovery time (PSRT). Pain control, adverse events, and acupoint names reported in the included studies were also investigated.Of the 211 reviewed abstracts, 9 studies (702 patients) met eligibility criteria and were included in the present systematic review and meta‑analysis. Compared to control groups, acupuncture groups showed a significant reduction in time to postoperative oral food intake [standardized mean difference (SMD) = -0.77, 95% confidence interval (CI) -1.18 to -0.35], time to first flatus (SMD=-0.81, 95% CI -1.13 to -0.48), time to first defecation (SMD=-0.91, 95% CI -1.41 to -0.41, PSRT (SMD=-0.92, 95% CI -1.93 to 0.08), and pain intensity (SMD=-0.60, 95% CI -0.83 to -0.37).The Zusanli (ST36) and Shangjuxu (ST37) acupoints were used in eight of the nine included studies. Adverse events related to acupuncture were observed in two studies, and only one case of bruising was reported.The present systematic review and meta‑analysis suggested that acupuncture significantly improves recovery of gastrointestinal function and pain control in tumor patients receiving the ERAS protocol compared to the control group. Moreover, ST36 and ST37 were the most frequently used acupoints. Although the safety of acupuncture was poorly described in the included studies, the available data suggested that acupuncture is a safe treatment with only mild side effects. These findings provide evidence-based recommendations for the inclusion of acupuncture in the ERAS protocol for tumor patients.https://www.crd.york.ac.uk/prospero/ PROSPERO, identifier CRD42023430211.Copyright © 2023 Chen, Fu, Liu, Xie and Li.