Hu Caiqiong, Zhang Haibo, Wu Wanyin, Yu Weiqing, Li Yong, Bai Jianping, Luo Baohua, Li Shuping
The Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China.
Evid Based Complement Alternat Med. 2016;2016:1720239. doi: 10.1155/2016/1720239. Epub 2016 Feb 10.
Objective. To evaluate the effectiveness and safety of acupuncture for cancer-related pain. Methods. A systematic review of literatures published from database inception to February 2015 was conducted in eight databases. RCTs involving acupuncture for treatment of cancer-related pain were identified. Two researchers independently performed article selection, data extraction, and quality assessment of data. Results. 1,639 participants in twenty RCTs were analyzed. All selected RCTs were associated with high risk of bias. Meta-analysis indicated that acupuncture alone did not have superior pain-relieving effects as compared with conventional drug therapy. However, as compared with the drug therapy alone, acupuncture plus drug therapy resulted in increased pain remission rate, shorter onset time of pain relief, longer pain-free duration, and better quality of life without serious adverse effects. However, GRADE analysis revealed that the quality of all outcomes about acupuncture plus drug therapy was very low. Conclusions. Acupuncture plus drug therapy is more effective than conventional drug therapy alone for cancer-related pain. However, multicenter high-quality RCTs with larger sample sizes are needed to provide stronger evidence for the effectiveness of acupuncture in cancer-related pain due to the low data quality of the studies included in the current meta-analysis.
目的。评估针刺治疗癌症相关疼痛的有效性和安全性。方法。对从数据库建库至2015年2月发表的文献进行系统回顾，检索了八个数据库。纳入针刺治疗癌症相关疼痛的随机对照试验（RCT）。两名研究人员独立进行文献筛选、数据提取和数据质量评估。结果。分析了20项RCT中的1639名参与者。所有入选的RCT均存在较高的偏倚风险。Meta分析表明，与传统药物治疗相比，单纯针刺并无更优的止痛效果。然而，与单纯药物治疗相比，针刺联合药物治疗可提高疼痛缓解率，缩短疼痛缓解起效时间，延长无痛持续时间，改善生活质量，且无严重不良反应。然而，GRADE分析显示，针刺联合药物治疗所有结局的证据质量均很低。结论。针刺联合药物治疗癌症相关疼痛比单纯传统药物治疗更有效。然而，由于当前Meta分析纳入研究的数据质量较低，需要开展多中心、大样本量的高质量RCT，为针刺治疗癌症相关疼痛的有效性提供更有力的证据。
