Chen Lawrence, Lin Chao-Chun, Huang Tsai-Wei, Kuan Yi-Chun, Huang Yao-Hsien, Chen Hung-Chou, Kao Chun-Yu, Su Chih-Ming, Tam Ka-Wai
Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Department of Nursing, College of Medicine and Nursing, HungKuang University, Taichung, Taiwan.
Breast. 2017 Jun;33:132-138. doi: 10.1016/j.breast.2017.03.015. Epub 2017 Apr 4.
Aromatase inhibitor (AI)-induced arthralgia (AIA) is a common side effect that may lead to premature discontinuation of effective hormonal therapy in patients with breast cancer. Acupuncture may relieve joint pain in patients with AIA. We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of acupuncture in pain relief in AIA.
The PubMed, Embase, Cochrane Library, and Scopus databases and the ClinicalTrials.gov registry were searched for studies published before February 2017. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate the pooled effect size by using a random effect model. Pain was assessed using the Brief Pain Inventory (BPI) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 3-4, 6-8, and 12 weeks. Secondary outcomes included disability level, upper extremity function, physical performance, and quality of life.
Five trials involving 181 patients were reviewed. Significant pain reduction was observed after 6-8 weeks of acupuncture treatment. Patients receiving acupuncture showed a significant decrease in the BPI worst pain score (weighted mean difference [WMD]: -3.81, 95% confidence interval [CI]: -5.15 to -2.47) and the WOMAC pain score (WMD: -130.77, 95% CI: -230.31 to -31.22) after 6-8 weeks of treatment. One of the 4 trials reported 18 minor adverse events in 8 patients during 398 intervention episodes.
Acupuncture is a safe and viable nonpharmacologic treatment that may relieve joint pain in patients with AIA. Additional studies involving a higher number of RCTs are warranted.
芳香化酶抑制剂（AI）引起的关节痛（AIA）是一种常见的副作用，可能导致乳腺癌患者过早停用有效的激素治疗。针灸可能缓解AIA患者的关节疼痛。我们进行了一项随机对照试验（RCT）的荟萃分析，以评估针灸缓解AIA疼痛的有效性。
检索了PubMed、Embase、Cochrane图书馆、Scopus数据库以及ClinicalTrials.gov注册库中2017年2月之前发表的研究。对个体效应量进行标准化，并使用随机效应模型进行荟萃分析以计算合并效应量。在3 - 4周、6 - 8周和12周时，使用简明疼痛量表（BPI）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估疼痛。次要结局包括残疾水平、上肢功能、身体表现和生活质量。
对5项涉及181例患者的试验进行了综述。针灸治疗6 - 8周后观察到疼痛显著减轻。接受针灸治疗的患者在治疗6 - 8周后，BPI最严重疼痛评分（加权平均差[WMD]：-3.81，95%置信区间[CI]：-5.15至-2.47）和WOMAC疼痛评分（WMD：-130.77，95%CI：-230.31至-31.22）显著降低。4项试验中的1项报告在398次干预期间，8例患者出现18起轻微不良事件。
针灸是一种安全可行的非药物治疗方法，可能缓解AIA患者的关节疼痛。需要开展更多涉及更多RCT的研究。
