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针刺治疗乳腺癌芳香化酶抑制剂相关关节痛:一项系统评价与荟萃分析。

Acupuncture for treating aromatase inhibitor-related arthralgia in breast cancer: a systematic review and meta-analysis.

作者信息

Chien Tsai-Ju, Liu Chia-Yu, Chang Yi-Fang, Fang Ching-Ju, Hsu Chung-Hua

机构信息

1 Institute of Traditional Medicine, National Yang-Ming University , Taipei, Taiwan .

出版信息

J Altern Complement Med. 2015 May;21(5):251-60. doi: 10.1089/acm.2014.0083. Epub 2015 Apr 27.

Abstract

PURPOSE

Acupuncture has been used as a complementary medical treatment for arthralgia and other types of pain. The objective of this review is to assess the effectiveness of acupuncture in the treatment of arthralgia in patients with breast cancer who were treated with aromatase inhibitors (AIs).

METHODS

A literature search was performed, without language restrictions, of 10 databases from their inception through February 2014. The literature reviewed included randomized clinical trials (RCTs) and clinical trials that compared real versus sham acupuncture for the treatment of AI-related musculoskeletal symptoms (AIMSS). The methodologic quality of these trials was assessed by using the modified Jadad Quality Scale. Meta-analytic software (RevMan 5.0) was used to analyze the data.

RESULTS

Five To compare the effects of real versus sham acupuncture, five RCTs were assessed by meta-analysis and quality analysis. Three of the RCTs reported favorable effects with regard to use of acupuncture in reducing pain and joint-related symptoms, while the other two RCTs did not. The meta-analysis showed trends toward reduced pain and stiffness in patients given acupuncture compared with those who received sham treatment (n=82; pain, mean difference: -2.07 [95% confidence interval (CI), -4.72 to 0.57]; p=0.12; stiffness, mean difference: -86.10 [95% CI, -249.11 to 76.92]; p=0.30), although these differences were not statistically significant.

CONCLUSIONS

Acupuncture has been reported as a safe and promising treatment for AIMSS, but the present analysis indicated that the effects were not statistically significant. Other outcome measurements, such as imaging studies, would be worth including in future studies to further confirm the efficacy of acupuncture in AIMSS.

摘要

目的

针灸已被用作关节痛及其他类型疼痛的辅助治疗方法。本综述的目的是评估针灸对接受芳香化酶抑制剂(AIs)治疗的乳腺癌患者关节痛的治疗效果。

方法

对10个数据库从创建至2014年2月进行了无语言限制的文献检索。所综述的文献包括随机临床试验(RCTs)以及比较真针灸与假针灸治疗AI相关肌肉骨骼症状(AIMSS)的临床试验。采用改良的Jadad质量量表评估这些试验的方法学质量。使用Meta分析软件(RevMan 5.0)分析数据。

结果

为比较真针灸与假针灸的效果,通过Meta分析和质量分析评估了5项RCTs。其中3项RCTs报告称针灸在减轻疼痛和关节相关症状方面有良好效果,而另外2项RCTs则未发现此效果。Meta分析显示,与接受假治疗的患者相比,接受针灸治疗的患者疼痛和僵硬程度有减轻趋势(n = 82;疼痛,平均差值:-2.07 [95%置信区间(CI),-4.72至0.57];p = 0.12;僵硬,平均差值:-86.10 [95% CI,-249.11至76.92];p = 0.30),尽管这些差异无统计学意义。

结论

针灸已被报道为一种治疗AIMSS安全且有前景的方法,但目前的分析表明其效果无统计学意义。未来研究中纳入其他结局指标,如影像学研究,将有助于进一步证实针灸治疗AIMSS的疗效。

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