Xu Ling, Lao Li Xing, Ge Adeline, Yu Shan, Li Jie, Mansky Patrick J
Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
Integr Cancer Ther. 2007 Sep;6(3):208-34. doi: 10.1177/1534735407305705.
The purpose of this review is to summarize and evaluate the current status of clinical research on the use of Chinese herbal medicine in treating cancer pain, with emphasis on the efficacy and safety of the applications.
A search of the clinical research published between 1986 and 2006 on the effects and applications of Chinese herbal medicine in cancer pain management was conducted using databases of CBM, CMCC, Wanfang, and Weipu (available since 1989) in Chinese and PubMed and EMBASE in English. We included only reports of original publications on cancer-induced pain, resulting in a total of 115 articles. We evaluated the methodological quality of the articles following the guidelines set forth as "Levels of Evidence of Human Studies of Cancer in Complementary and Alternative Medicine" by the National Cancer Institute.
Various methods of traditional Chinese medicine herbal treatment for cancer pain management have been reported. These methods include external application, oral administration, intravenous infusion, and other applications such as inhalation and clysmata. Forty-one of the 115 studies reviewed were randomized controlled clinical trials, most comparing the effects of Chinese herbal medicine to conventional analgesics and the others using placebo controls. These trials suggest that (1) Chinese medicine may be effective for cancer pain, and its effects are similar to those of Western analgesics; (2) Chinese medicine may reduce the side effects of conventional analgesics, thus enhancing cancer patients' quality of life; and (3) the various methods of application--topical, oral, and intravenous--are suitable to treat a range of pain conditions found in cancer patients. However, trials were of varying quality with respect to control group selection, dosing and side effect information, and outcome measures.
The studies reviewed in this article suggest that Chinese herbal medicine may be useful for managing cancer pain, at least for short-term application. The products evaluated appear relatively safe, with no serious adverse effects reported. However, the quality of the published reports is variable. More research using rigorously controlled clinical trial design is warranted.
本综述旨在总结和评估中药治疗癌痛的临床研究现状，重点关注其应用的有效性和安全性。
使用中国生物医学文献数据库（CBM）、中国医学科普文献数据库（CMCC）、万方数据库以及维普数据库（自1989年起可用）检索1986年至2006年间发表的关于中药在癌痛管理中的作用及应用的临床研究，同时使用英文的PubMed和EMBASE数据库进行检索。我们仅纳入关于癌性疼痛的原始发表报告，共获得115篇文章。我们按照美国国立癌症研究所制定的“补充和替代医学中癌症人体研究的证据水平”指南评估文章的方法学质量。
已报道多种中药治疗癌痛的方法。这些方法包括外用、口服、静脉输注以及其他应用方式，如吸入和灌肠。在115项纳入综述的研究中，41项为随机对照临床试验，大多数将中药的效果与传统镇痛药进行比较，其他则使用安慰剂对照。这些试验表明：（1）中药可能对癌痛有效，其效果与西方镇痛药相似；（2）中药可能减少传统镇痛药的副作用，从而提高癌症患者的生活质量；（3）外用、口服和静脉注射等多种应用方式适用于治疗癌症患者中发现的一系列疼痛情况。然而，在对照组选择、给药和副作用信息以及结局测量方面，试验质量参差不齐。
本文综述的研究表明，中药可能对癌痛管理有用，至少在短期应用中如此。所评估的产品似乎相对安全，未报告严重不良反应。然而，已发表报告的质量参差不齐。需要进行更多采用严格对照临床试验设计的研究。
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