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针刺疗法减轻癌症相关疼痛的系统评价与Meta分析

Systematic review and meta-analysis of acupuncture to reduce cancer-related pain.

作者信息

Chiu H Y, Hsieh Y J, Tsai P S

机构信息

School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.

出版信息

Eur J Cancer Care (Engl). 2017 Mar;26(2). doi: 10.1111/ecc.12457. Epub 2016 Feb 7.

Abstract

We conducted a systematic review and meta-analysis to evaluate the effects of acupuncture on malignancy-related, chemotherapy (CT)- or radiation therapy (RT)-induced, surgery-induced, and hormone therapy (HT)-induced pain. Randomised controlled trials (RCTs) examining the effects of acupuncture on cancer-related pain were reached from the EMBASE, PubMed, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, Airiti library, Taiwan Electrical Periodical Service, Wanfang Data (a Chinese database) and China Knowledge Resource Integrated Database from inception through June 2014. Heterogeneity, moderator analysis, publication bias and risk of bias associated with the included studies were examined. A total of 29 RCTs yielding 36 effect sizes were included. The overall effect of acupuncture on cancer-related pain was -0.45 [95% confidence interval (CI) = -0.63 to -0.26]. The subanalysis indicated that acupuncture relieved malignancy-related and surgery-induced pain [effect size (g) = -0.71, and -0.40; 95% CI = -0.94 to -0.48, and -0.69 to -0.10] but not CT- or RT-induced and HT-induced pain (g = -0.05, and -0.64, 95% CI = -0.33 to 0.24, and -1.55 to 0.27). Acupuncture is effective in relieving cancer-related pain, particularly malignancy-related and surgery-induced pain. Our findings suggest that acupuncture can be adopted as part of a multimodal approach for reducing cancer-related pain.

摘要

我们进行了一项系统评价和荟萃分析,以评估针刺对恶性肿瘤相关、化疗(CT)或放疗(RT)引起、手术引起以及激素治疗(HT)引起的疼痛的影响。通过检索EMBASE、PubMed、PsycINFO、Cochrane对照试验中央注册库、CINAHL、华艺数位图书馆、台湾电子期刊服务、万方数据(一个中文数据库)和中国知网,从建库至2014年6月获取了研究针刺对癌症相关疼痛影响的随机对照试验(RCT)。检查了纳入研究的异质性、调节因素分析、发表偏倚和偏倚风险。共纳入29项产生36个效应量的RCT。针刺对癌症相关疼痛的总体效应为-0.45[95%置信区间(CI)=-0.63至-0.26]。亚组分析表明,针刺可缓解恶性肿瘤相关和手术引起的疼痛[效应量(g)=-0.71和-0.40;95%CI=-0.94至-0.48和-0.69至-0.10],但对CT或RT引起以及HT引起的疼痛无效(g=-0.05和-0.64,95%CI=-0.33至0.24和-1.55至0.27)。针刺在缓解癌症相关疼痛方面有效,尤其是恶性肿瘤相关和手术引起的疼痛。我们的研究结果表明,针刺可作为减轻癌症相关疼痛的多模式方法的一部分采用。

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