Lafferty William E, Downey Lois, McCarty Rachelle L, Standish Leanna J, Patrick Donald L
University of Washington, School of Public Health and Community Medicine, Department of Health Services, Seattle, WA 98195, USA.
Complement Ther Med. 2006 Jun;14(2):100-12. doi: 10.1016/j.ctim.2006.01.009. Epub 2006 Mar 29.
There is a pressing need for improved end-of-life care. Use of complementary and alternative medicine (CAM) may improve the quality of care but few controlled trials have evaluated CAM at the end of life.
To determine the strength of evidence for the benefits of touch and mind-body therapies in seriously ill patients.
Systematic review of randomized controlled trials of massage and mind-body therapies. A PubMed search of English language articles was used to identify the relevant studies.
Of 27 clinical trials testing massage or mind-body interventions, 26 showed significant improvements in symptoms such as anxiety, emotional distress, comfort, nausea and pain. However, results were often inconsistent across studies and there were variations in methodology, so it was difficult to judge the clinical significance of the results.
Use of CAM at the end of life is warranted on a case-by-case basis. Limitations in study design and sample size of the trials analyzed mean that routine use of CAM cannot be supported. There are several challenges to be addressed in future research into the use of CAM in end-of-life patients.
改善临终关怀的需求迫在眉睫。使用补充和替代医学（CAM）可能会提高护理质量，但很少有对照试验评估过临终时的CAM。
确定触摸和身心疗法对重症患者益处的证据强度。
对按摩和身心疗法的随机对照试验进行系统评价。使用PubMed搜索英文文章以识别相关研究。
在27项测试按摩或身心干预的临床试验中，26项显示出焦虑、情绪困扰、舒适度、恶心和疼痛等症状有显著改善。然而，各研究结果往往不一致，且方法存在差异，因此难以判断结果的临床意义。
临终时使用CAM应根据具体情况而定。所分析试验的研究设计和样本量存在局限性，这意味着不能支持常规使用CAM。在未来关于临终患者使用CAM的研究中，有几个挑战需要解决。
