I thought I'd check out this port now the coin-op works in MAME, but nothing seems to run it. Picodrive loops back to the title screen when you press the fire button, SMSPlus-GX starts the game but no movement controls work (the fire button does), and GearSystem loads it but nothing does anything on the title screen.
FBNeo-SMS gets closest - the game starts but the controls are totally wonky. Right and left are back to front and you can't move into the left-hand half of the screen.
Apparently Megumi Rescue was one of only four games to require the SMS paddle controllers, which I didn't even know existed. The only SMS emulator I can find with explicit paddle support is GenesisPlus-GX, but that won't boot the game even if I force it to run as a Japanese Master System. (SMSPlus-GX, weirdly, doesn't have the Master System controller options that GP-GX does.)