Peng Hao, Peng Hai-Dong, Xu Ling, Lao Li-Xing
Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Zhong Xi Yi Jie He Xue Bao. 2010 Jun;8(6):501-9. doi: 10.3736/jcim20100601.
Although acupuncture is a well-established treatment for cancer pain and its effects have been widely reported in recent two decades, there is still controversy over whether its efficacy is better than placebo.
To evaluate the efficacy of acupuncture therapy on cancer pain.
Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2008), EMBASE, PubMed, ScienceDirect database, Current Controlled Trials, Chongqin VIP database and CNKI database were searched, and the search date ended in June 2008. The authors also hand-searched six Chinese Journals related to the question.
All randomized controlled trials (RCTs) comparing acupuncture therapy with placebo, Western drugs, Chinese herbal medicines, or comparing acupuncture therapy plus drug treatment with drug treatment.
Two separate evaluators assessed the quality of the included reports and extracted the useful information. Disagreements were resolved through discussion. Meta-analysis of the included trials was done with RevMan 5.0, and qualitative analysis was employed when meta-analysis was not appropriate.
Seven published RCTs with a total of 634 patients met the inclusion criteria, and the quality of one of the included trials was high. Due to flaws in design and reporting, meta-analysis was precluded, and only qualitative analysis was done on the majority of the reports. The high-quality trial showed that auricular acupuncture therapy was significantly superior to placebo in pain alleviation. The other six low-quality trials with non-placebo showed that acupuncture therapy had some positive effects.
Acupuncture is effective for pain relief. However, the poor quality of the majority of the trials reduces the reliability of the conclusion. More high-quality RCTs are needed to verify the effects.
尽管针灸是一种成熟的癌症疼痛治疗方法,且其效果在近二十年已得到广泛报道,但关于其疗效是否优于安慰剂仍存在争议。
评估针刺疗法对癌症疼痛的疗效。
检索了Cochrane对照试验中心注册库(《Cochrane图书馆》,2008年第3期)、EMBASE、PubMed、ScienceDirect数据库、当前对照试验、重庆维普数据库和中国知网数据库,检索日期截至2008年6月。作者还手工检索了与该问题相关的六种中文期刊。
所有比较针刺疗法与安慰剂、西药、中药的随机对照试验(RCT),或比较针刺疗法加药物治疗与单纯药物治疗的试验。
两名独立评估者评估纳入报告的质量并提取有用信息。分歧通过讨论解决。使用RevMan 5.0对纳入试验进行Meta分析,在不适合进行Meta分析时采用定性分析。
七项已发表的RCT共纳入634例患者,符合纳入标准,其中一项纳入试验质量高。由于设计和报告存在缺陷,无法进行Meta分析,多数报告仅进行了定性分析。高质量试验表明耳针疗法在缓解疼痛方面显著优于安慰剂。其他六项非安慰剂对照的低质量试验表明针刺疗法有一些积极效果。
针刺对缓解疼痛有效。然而,多数试验质量较差降低了结论的可靠性。需要更多高质量的RCT来验证其效果。