按壓或穴位按壓對肌肉注射疼痛的改善成效

Effectiveness of Manual Pressure or Acupressure to Relieve Intramuscular Injection Pain

減輕肌肉注射疼痛，能提高病人的施打意願及治療遵從性。本文以系統性文獻回顧及統合分析，選取相關研究，希冀確認肌肉注射前按壓或穴位按壓對減輕疼痛的成效。以關鍵字並搭配自然語言及Mesh term，於7個資料庫進行搜尋2023年12月前的中、英文文獻，總計納入9篇包括隨機對照試驗（Randomized Controlled Trials, RCT）及類實驗研究的文獻，並用grading of recommendations assessment, development and evaluation（GRADE）及Joanna Briggs Institute（JBI）評續工具檢測證據品質。9篇研究共962位病人，樣本數範圍為30至150人。統合分析發現，不管是按壓注射部位（-0.81, 95% CI:-1.22, -0.39）或按壓特定穴位（-2.89; 95% CI:-4.57. -1.21），皆顯示兩者對減輕注射後的疼痛達顯著統計成效。依據本研究結果，建議：手臂肌肉注射前按壓注射部位10秒或背臀肌注射前以1-1.2英吋或4.5kg/cm2的壓力按壓上髎、次髎及環跳穴，1分鐘3次，每次2秒，以減輕肌肉注射後疼痛。

Reducing the pain of intramuscular injection can improve the patient’s willingness to inject and treatment compliance. This article uses a systematic literature review and meta-analysis to screen relevant studies, aiming to confirm the effectiveness of compression or acupressure before intramuscular injection in reducing pain. We searched Chinese and English research articles before December 2023 in 7 databases using keywords, natural language and Mesh terms. In total, 9 articles were included. Quality reviews of the articles were conducted using the GRADE and Joanna Briggs Institute (JBI 2020) Critical Appraisal Checklist for RCTs and Quasi-Experimental Studies. There were 9 studies with a total of 962 participants, and the sample size ranged from 30 to 150 people. A meta-analysis was conducted, and the results showed that whether manual pressure (-0.81, 95% CI:-1.22, -0.39) or acupressure (-2.89; 95% CI:-4.57, -1.21) before an intramuscular injection were able to significantly reduce post-injection pain. It is therefore advisable to apply manual pressure directly to the injection site on the arm using a thumb for 10 seconds before an intramuscular injection. Alternatively, it is suggested that acupressure be applied on the UB31(BL31), UB32(BL32), and GB30 acupoints, 3 times per minute, with each application lasting 2 seconds, to relieve pain after intramuscular injection.