University of Birmingham, United Kingdom.
Complement Ther Med. 2013 Aug;21(4):417-29. doi: 10.1016/j.ctim.2013.05.003. Epub 2013 Jun 3.
To assess whether quality of life (QOL) improved in cancer survivors who had undertaken a complementary and alternative medicine (CAM) intervention, compared to cancer survivors who had not.
A systematic review of randomised controlled trials (RCTs) was undertaken. Electronic databases including MEDLINE, Cochrane CENTRAL, CINAHL, PSYCHINFO, EMBASE, and ClinicalTrials.gov were searched from 1990 to 2012. Search terms incorporating the concepts of cancer survivors, QOL and various types of CAM were used.
From 1767 records retrieved and screened 13 full text articles were included in the review. Nine studies were deemed to have a high risk, one a low risk, and three an unclear risk of bias. CAM interventions used incorporated yoga, meditation or mindfulness, energy healing, medical qigong, homoeopathy, or mistletoe therapy. Ten of the studies used breast cancer survivors, whilst the remaining three included other cancer types. The studies had mixed results either showing a significantly greater improvement in QOL in the intervention group compared to the control group, or no significant difference between groups. However, twelve studies were of low to moderate quality, limiting the robustness of findings.
This review has identified significant gaps in the evidence base for the effectiveness of CAM on QOL in cancer survivors. Further work in this field needs to adopt more rigorous methodology to help support cancer survivors to actively embrace self-management and effective CAMs, without recommending inappropriate interventions which are of no proven benefit.
评估与未接受补充和替代医学（CAM）干预的癌症幸存者相比，接受 CAM 干预的癌症幸存者的生活质量（QOL）是否有所改善。
进行了一项随机对照试验（RCT）的系统评价。电子数据库包括 MEDLINE、Cochrane 中心、CINAHL、PSYCHINFO、EMBASE 和 ClinicalTrials.gov，从 1990 年到 2012 年进行了搜索。使用了包含癌症幸存者、QOL 和各种类型的 CAM 概念的搜索词。
从检索到的 1767 条记录中筛选出 13 篇全文文章纳入了综述。9 项研究被认为具有高风险，1 项具有低风险，3 项具有不确定的偏倚风险。CAM 干预措施包括瑜伽、冥想或正念、能量疗愈、医疗气功、顺势疗法或槲寄生疗法。其中 10 项研究使用了乳腺癌幸存者，而其余 3 项研究则包括了其他癌症类型。这些研究的结果不一致，要么显示干预组的 QOL 显著改善，要么显示两组之间无显著差异。然而，有 12 项研究的质量为低至中等，限制了研究结果的稳健性。
本综述确定了关于 CAM 对癌症幸存者 QOL 的有效性的证据基础存在显著差距。该领域的进一步研究需要采用更严格的方法学，以帮助支持癌症幸存者积极采取自我管理和有效的 CAM，而不推荐没有经过证实的益处的不适当干预措施。
