Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China.
Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Nanxiaojie, Dongzhimennei Avenue, Beijing 100700, China.
Evid Based Complement Alternat Med. 2014;2014:170396. doi: 10.1155/2014/170396. Epub 2014 Apr 13.
Background and Objective. Now with more and more published systematic reviews of Complementary and Alternative Medicine (CAM) on adult cancer pain, it is necessary to use the methods of overview of systematic review to summarize available evidence, appraise the evidence level, and give suggestions to future research and practice. Methods. A comprehensive search (the Cochrane Library, PubMed, Embase, and ISI Web of Knowledge) was conducted to identify all systematic reviews or meta-analyses of CAM on adult cancer pain. And the evidence levels were evaluated using GRADE approach. Results. 27 systematic reviews were included. Based on available evidence, we could find that psychoeducational interventions, music interventions, acupuncture plus drug therapy, Chinese herbal medicine plus cancer therapy, compound kushen injection, reflexology, lycopene, TENS, qigong, cupping, cannabis, Reiki, homeopathy (Traumeel), and creative arts therapies might have beneficial effects on adult cancer pain. No benefits were found for acupuncture (versus drug therapy or shame acupuncture), and the results were inconsistent for massage therapy, transcutaneous electric nerve stimulation (TENS), and Viscum album L plus cancer treatment. However, the evidence levels for these interventions were low or moderate due to high risk of bias and/or small sample size of primary studies. Conclusion. CAM may be beneficial for alleviating cancer pain, but the evidence levels were found to be low or moderate. Future large and rigor randomized controlled studies are needed to confirm the benefits of CAM on adult cancer pain.
背景与目的。现在,关于补充和替代医学(CAM)治疗成人癌症疼痛的系统评价越来越多,有必要使用系统评价综述的方法来总结现有证据,评估证据水平,并为未来的研究和实践提供建议。方法。全面检索(Cochrane 图书馆、PubMed、Embase 和 ISI Web of Knowledge)以确定所有关于成人癌症疼痛的 CAM 的系统评价或荟萃分析。并使用 GRADE 方法评估证据水平。结果。共纳入 27 篇系统评价。基于现有证据,我们可以发现心理教育干预、音乐干预、针刺加药物治疗、中药加癌症治疗、复方苦参注射液、反射疗法、番茄红素、经皮神经电刺激(TENS)、气功、拔罐、大麻、灵气疗法、顺势疗法(Traumeel)和创意艺术疗法可能对成人癌症疼痛有有益的效果。针刺(与药物治疗或羞耻针刺相比)和按摩疗法、经皮神经电刺激(TENS)以及 Viscum album L 加癌症治疗的结果不一致,没有发现益处。然而,由于偏倚风险高和/或主要研究的样本量小,这些干预措施的证据水平较低或中等。结论。CAM 可能有助于缓解癌症疼痛,但证据水平较低或中等。需要未来的大型、严格的随机对照研究来证实 CAM 对成人癌症疼痛的益处。