Lee Seunghoon, Jerng Ui Min, Liu Yan, Kang Jung Won, Nam Dongwoo, Lee Jae-dong
Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University, Seoul, South Korea.
Support Care Cancer. 2014 May;22(5):1429-40. doi: 10.1007/s00520-014-2161-z. Epub 2014 Mar 8.
Among cancer patients, cancer-related fatigue (CRF) is one of the most common symptoms and adversely affects physical ability and quality of life even several years after treatment. This study aims to evaluate the current evidence for moxibustion in patients with CRF.
Eighteen databases were searched from their inception to April 2013. All randomized controlled trials (RCTs) of moxibustion for treating CRF without language restriction were considered for inclusion. The risk of bias and reporting quality of each study were assessed using the Cochrane risk of bias tool, Consolidated Standards of Reporting Trials (CONSORT), and Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). Risk ratio (RR) or mean difference (MD) was used to measure the treatment effect with 95 % confidence intervals (CIs) in a random effects model.
Four RCTs with a total of 374 subjects were included for the review. These four studies compared moxibustion plus routine care with routine care alone. Most studies were determined to have a moderate to high risk of bias with low reporting quality. An indirect moxa stick was used in two studies, an indirect ginger cake-separated moxa was used in one study, and in one remaining study, both moxibustion methods were used. Meta-analysis showed the favorable effects of moxibustion on the response rate (RR, 1.73; 95 % CI, 1.29 to 2.32; p=.0003; heterogeneity, I (2)=15 %, p=.32). Burning with a mild blister after moxibustion was reported in one study.
Because of a high risk of bias and low reporting quality of the studies included in this review, it is difficult to draw the conclusion that moxibustion is an effective and safe treatment for patients with CRF. Further rigorous research will be necessary to evaluate whether moxibustion has beneficial effects on CRF.
PROSPERO. Unique identifier: CRD42013004501.
在癌症患者中，癌症相关疲劳（CRF）是最常见的症状之一，即使在治疗后数年仍会对身体能力和生活质量产生不利影响。本研究旨在评估艾灸治疗CRF患者的现有证据。
检索了18个数据库，时间跨度从建库至2013年4月。纳入所有艾灸治疗CRF且无语言限制的随机对照试验（RCT）。使用Cochrane偏倚风险工具、报告试验的统一标准（CONSORT）以及针灸临床试验干预报告修订标准（STRICTA）评估每项研究的偏倚风险和报告质量。采用随机效应模型，用风险比（RR）或平均差（MD）衡量治疗效果，并给出95%置信区间（CI）。
本综述纳入了4项RCT，共374名受试者。这4项研究将艾灸加常规护理与单纯常规护理进行了比较。大多数研究被判定存在中度至高偏倚风险，报告质量较低。两项研究使用了间接艾条，一项研究使用了间接隔姜灸，另一项研究同时使用了两种艾灸方法。荟萃分析显示艾灸对缓解率有显著效果（RR，1.73；95%CI，1.29至2.32；p = 0.0003；异质性，I² = 15%，p = 0.32）。一项研究报告了艾灸后出现轻度水泡。
由于本综述纳入的研究存在高偏倚风险和低报告质量，难以得出艾灸是治疗CRF患者的有效且安全方法的结论。需要进一步进行严谨的研究来评估艾灸对CRF是否有有益效果。
PROSPERO。唯一标识符：CRD42013004501。
