韩建萍：研究设计、数据整理、图表绘制、论文撰写；任亚星：文献检索与筛选、数据整理、文献质量评价、作图；李影、候朋晓、王亚丽：文献检索与筛选、数据整理、文献质量评价；鄂海燕：研究设计、论文修改、论文指导、质量控制
收稿日期: 2025-09-02
网络出版日期: 2026-07-01
基金资助
中央高水平中医医院临床科研业务费资助(DFRC-QHTS2025-006)
A study on the construction of evidence map for non-pharmacological analgesia in critically ill patients
Received date: 2025-09-02
Online published: 2026-07-01
Supported by
National High Level Chinese Medicine Hospital Clinical Research Funding(DFRC-QHTS2025-006)
目的 系统描述及评价非药物干预重症患者疼痛现状及相关证据，以期为临床非药物镇痛的研究与应用提供循证支持。方法 检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、维普数据库、万方数据库，获取近10年非药物干预重症患者疼痛的系统评价或Meta分析。严格按照纳入和排除标准筛选文献，采用系统评价偏倚风险评估工具2进行方法学质量评价；采用证据图谱综合呈现纳入文献的相关信息。结果 共纳入15篇文献，涉及7种非药物镇痛措施：虚拟现实技术、针刺类疗法、按摩推拿、音乐干预、引导意象、精神照护、芳香疗法等。纳入文献结果提示，非药物干预在缓解重症患者疼痛方面具有一定效果。质量评价结果显示，文献整体方法学质量不高，高级2篇，中级4篇，低级6篇，极低级3篇。证据图谱结果表明，4项研究结论为有益，9项为可能有益，1项为无差异性效应，1项为不确定。结论 现有证据表明，非药物干预能缓解重症患者疼痛情况，但相关研究的方法学质量有待提高。建议今后开展规范的、高质量研究，为重症患者疼痛的非药物干预提供更科学可靠的证据支持。
韩建萍 , 任亚星 , 李影 , 候朋晓 , 王亚丽 , 鄂海燕 . 重症患者非药物镇痛证据图谱的构建研究[J]. 中华急危重症护理杂志, 2026 , 7(7) : 827 -835 . DOI: 10.3761/j.issn.2096-7446.2026.07.008
Objective To systematically describe and evaluate the current situation and relevant evidence of non-pharmaceutical intervention for pain in critically ill patients，to provide evidence-based support for the application of non-pharmaceutical analgesia in clinical practice. Methods PubMed，Embase，Cochrane Library，Web of Science，CINAHL，CNKI，VIP，and Wanfang databases were retrieved to obtain systematic reviews or meta-analyses of pain in critically ill patients with non-pharmaceutical interventions in the past 10 years. Literature was screened strictly in accordance with the inclusion and exclusion criteria，and the methodological quality of the included literature was evaluated using A Measurement Tool to Assess Systematic Reviews 2（AMSTAR 2）. The relevant information of the included literature was comprehensively presented by using the evidence map. Results A total of 15 articles were included in this study，including 7 non-pharmaceutical analgesic measures：virtual reality technology，acupuncture therapy，massage，music intervention，guided imagery，spiritual care，and aromatherapy. The included literature suggested that non-pharmacological interventions had a certain effect in relieving pain in critically ill patients. The quality evaluation results showed that the overall methodological quality of the papers was low，with 2 papers rated as high，4 as intermediate，6 as low，and 3 as very low. The results of the evidence map showed that the conclusions of 4 studies were beneficial，9 were possibly beneficial，1 had no differential effect，and 1 was uncertain. Conclusion The current evidence shows that non-pharmacological interventions can relieve pain in critically ill patients，but the methodological quality of relevant studies needs to be improved. It is suggested that standardized and high-quality research should be carried out in the future to provide more scientific and reliable evidence to support non-pharmacological interventions for pain in critically ill patients.
| [1] | Raja SN, Carr DB, Cohen M, et al. The revised International Association for the Study of Pain definition of pain:concepts,challenges,and compromises[J]. Pain, 2020, 161(9):1976-1982. |
| [2] | Lang J. Appraisal of clinical practice guideline:clinical practice guidelines for the prevention and management of pain,agitation/sedation,delirium,immobility,and sleep disruption in adult patients in the ICU[J]. J Physiother, 2022, 68(4):282. |
| [3] | Damico V, Macchi G, Murano L, et al. Incidence of pain at rest and during nursing procedures in ICU patients:a longitudinal observational study[J]. Ann Ig, 2020, 32(4):407-418. |
| [4] | 于天灏, 陈香萍, 尹金瑜, 等. 成人有创机械通气患者气道内吸引操作性疼痛的研究进展及启示[J]. 中华急危重症护理杂志, 2024, 5(10):920-925. |
| Yu TH, Chen XP, Yin JY, et al. Research progress and insights into pain induced by airway suction in adult patients with invasive mechanical ventilation[J]. Chin J Emerg Crit Care Nurs, 2024, 5(10):920-925. | |
| [5] | 尹金瑜, 陈香萍, 劳月文, 等. ICU转出患者慢性疼痛评估与预测工具的研究进展及启示[J]. 中华急危重症护理杂志, 2024, 5(10):926-931. |
| Yin JY, Chen XP, Lao YW, et al. Research progress and enlightenment of evaluation and prediction tools for chronic ICU-related pain[J]. Chin J Emerg Crit Care Nurs, 2024, 5(10):926-931. | |
| [6] | Devlin JW, Skrobik Y, Gélinas C, et al. Clinical practice guidelines for the prevention and management of pain,agitation/sedation,delirium,immobility,and sleep disruption in adult patients in the ICU[J]. Crit Care Med, 2018, 46(9):e825-e873. |
| [7] | Baldo BA. Toxicities of opioid analgesics:respiratory depression,histamine release,hemodynamic changes,hypersensitivity,serotonin toxicity[J]. Arch Toxicol, 2021, 95(8):2627-2642. |
| [8] | 中华医学会重症医学分会重症呼吸学组, 中国临床实践指南联盟. 中国成人重症患者镇痛管理专家共识[J]. 中华重症医学电子杂志, 2023, 9(2):97-115. |
| Chinese Medical Association Critical Care Medicine Branch Critical Respiratory Group, China Clinical Practice Guideline Alliance. Expert consensus on analgesic management in severe adult patients in China[J]. Chin J Crit Care Intensive Care Med Electron Ed, 2023, 9(2):97-115. | |
| [9] | 张玉坤, 王钰炜, 王飒, 等. 成人ICU患者疼痛管理的最佳证据总结[J]. 护理学报, 2021, 28(11):40-45. |
| Zhang YK, Wang YW, Wang S, et al. Summary of the best evidence of pain management in adult ICU patients[J]. J Nurs China, 2021, 28(11):40-45. | |
| [10] | 岳珑. 耳穴磁珠贴压辅助治疗机械通气患者镇痛镇静疗效观察及机制研究[D]. 北京: 中国中医科学院, 2022. |
| Yue L. Observation and mechanism of sedation and analgesia in patients with mechanical ventilation by ear point magnetic bead sticking[D]. Beijing: China Academy of Chinese Medical Sciences, 2022. | |
| [11] | Lu SY, Ji YY, Wang N, et al. Effectiveness of virtual reality on anxiety,pain,sleep quality,and post-traumatic stress disorder for critically ill patients in intensive care units:a systematic review and meta-analysis of randomised controlled trials[J]. Aust Crit Care, 2025, 38(4):101233. |
| [12] | 李艳飞, 李秀霞, 李睿, 等. 证据图谱的制作与报告[J]. 中国循证医学杂志, 2020, 20(9):1098-1103. |
| Li YF, Li XX, Li R, et al. Generation and reporting of evidence mapping[J]. Chin J Evid Based Med, 2020, 20(9):1098-1103. | |
| [13] | Li YF, Wei ZP, Zhang JY, et al. Wearing masks to reduce the spread of respiratory viruses:a systematic evidence mapping[J]. Ann Transl Med, 2021, 9(9):811. |
| [14] | Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2:a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions,or both[J]. BMJ, 2017,358:j4008. |
| [15] | 邓宏勇. 在线证据图谱(Evidence Map)绘制工具[EB/OL]. (2018-07-09)[2025-08-14]. https://www.pymeta.com/evdmap/. |
| Deng HY. Online Evidence Map drawing tool[EB/OL]. (2018-07-09)[2025-08-14]. https://www.pymeta.com/evdmap/. | |
| [16] | Papathanassoglou E, Pant U, Meghani S, et al. A systematic review of the comparative effects of sound and music interventions for intensive care unit patients’ outcomes[J]. Aust Crit Care, 2025, 38(3):101148. |
| [17] | Avc? A, Kaplan Serin E. The effect of music on pain in mechanically ventilated patients:a systematic review[J]. Nurs Crit Care, 2025, 30(2):e13270. |
| [18] | Li LL, Chen M, Yu NN, et al. Effectiveness of spiritual care interventions among patients in the intensive care unit:a systematic review and meta-analysis[J]. Nurs Crit Care, 2025, 30(3):e13202. |
| [19] | Biachi FB, de Oliveira Faria MF, Oliveira RA, et al. Effect of aromatherapy for postoperative pain management in the pos-tanesthesia recovery room:a systematic review[J]. J Perianesth Nurs, 2025, 40(4):1016-1023.e2. |
| [20] | Tan JXJ, Cai JS, Ignacio J. Effectiveness of aromatherapy on anxiety and sleep quality among adult patients admitted into intensive care units:a systematic review[J]. Intensive Crit Care Nurs, 2023, 76:103396. |
| [21] | Rababa M, Al-Sabbah S. The use of Islamic spiritual care practices among critically ill adult patients:a systematic review[J]. Heliyon, 2023, 9(3):e13862. |
| [22] | 马慧颖, 哈丽娜, 况莉, 等. 虚拟现实技术对重症患者ICU后综合征干预效果的系统评价[J]. 中国护理管理, 2022, 22(11):1706-1712. |
| Ma HY, Ha LN, Kuang L, et al. Effects of virtual reality technology on post-intensive care syndrome in critically ill patients:a systematic review[J]. Chin Nurs Manag, 2022, 22(11):1706-1712. | |
| [23] | Formenti P, Piuri G, Bisatti R, et al. Role of acupuncture in critically ill patients:a systematic review[J]. J Tradit Comple-ment Med, 2023, 13(1):62-71. |
| [24] | Monsalve-Duarte S, Betancourt-Zapata W, Suarez-Ca?on N, et al. Music therapy and music medicine interventions with adult burn patients:a systematic review and meta-analysis[J]. Burns, 2022, 48(3):510-521. |
| [25] | Richard-Lalonde M, Gélinas C, Boitor M, et al. The effect of music on pain in the adult intensive care unit:a systematic review of randomized controlled trials[J]. J Pain Symptom Manage, 2020, 59(6):1304-1319.e6. |
| [26] | Jagan S, Park T, Papathanassoglou E. Effects of massage on outcomes of adult intensive care unit patients:a systematic review[J]. Nurs Crit Care, 2019, 24(6):414-429. |
| [27] | Hadjibalassi M, Lambrinou E, Papastavrou E, et al. The effect of guided imagery on physiological and psychological outcomes of adult ICU patients:a systematic literature review and methodological implications[J]. Aust Crit Care, 2018, 31(2):73-86. |
| [28] | Boitor M, Gélinas C, Richard-Lalonde M, et al. The effect of massage on acute postoperative pain in critically and acutely ill adults post-thoracic surgery:systematic review and meta-analysis of randomized controlled trials[J]. Heart Lung, 2017, 46(5):339-346. |
| [29] | Hoffman HG, Richards TL, van Oostrom T, et al. The analgesic effects of opioids and immersive virtual reality distraction:evidence from subjective and functional brain imaging assessments[J]. Anesth Analg, 2007, 105(6):1776-1783. |
| [30] | Vora LK, Gholap AD, Hatvate NT, et al. Essential oils for clinical aromatherapy:a comprehensive review[J]. J Ethnopharmacol, 2024, 330:118180. |
| [31] | Pappas J, Sutton LA, Wilson DR. Guided imagery and other complementary pain control approaches for critical care patients[J]. Crit Care Nurs Clin N Am, 2024, 36(4):539-551. |
| [32] | 李晔, 杨琴, 徐媛媛. 五音疗法在骨性膝关节炎患者护理中的应用效果[J]. 中西医结合护理(中英文), 2024, 10(12):45-48. |
| Li Y, Yang Q, Xu YY. Application effect of five-tone therapy in the nursing of knee osteoarthritis patients[J]. J Clin Nurs Pract, 2024, 10(12):45-48. | |
| [33] | Andersson S, Lundeberg T. Acupuncture:from empiricism to science:functional background to acupuncture effects in pain and disease[J]. Med Hypotheses, 1995, 45(3):271-281. |
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