Chien Tsai-Ju, Hsu Chung-Hua, Liu Chia-Yu, Fang Ching-Ju
Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan.
Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-xing, Taipei City Hospital, Taipei, Taiwan.
PLoS One. 2017 Aug 22;12(8):e0180918. doi: 10.1371/journal.pone.0180918. eCollection 2017.
Many breast cancer patients suffer from hot flush and medical menopause as side effects of treatment. Some patients undergo acupuncture, rather than hormone therapy, to relieve these symptoms, but the efficacy of acupuncture is uncertain. This meta-analysis evaluated the efficacy of acupuncture on hot flush and menopause symptoms in women with breast cancer.
A literature search was performed, following the PRISMA Statement and without language restrictions, of 7 databases from inception through March 2017. All selected studies were randomized clinical trials (RCTs) that examined the effect of needle acupuncture on hot flush and menopause symptoms in patients with breast cancer. The methodological quality of these trials was assessed using Cochrane criteria, and meta-analysis software (RevMan 5.2) was used to analyze the data.
We examined 844 breast cancer patients (average age: 58 years-old) from 13 RCTs. The trials had medium-to-high quality, based on the modified Jadad scale. The meta-analysis showed that acupuncture had no significant effect on the frequency and the severity of hot flush (p = 0.34; p = 0.33), but significantly ameliorated menopause symptoms (p = 0.009). None of the studies reported severe adverse events.
Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer.
许多乳腺癌患者在治疗过程中会出现潮热和药物性绝经等副作用。一些患者选择针灸而非激素疗法来缓解这些症状，但针灸的疗效尚不确定。本荟萃分析评估了针灸对乳腺癌女性潮热和绝经症状的疗效。
按照PRISMA声明进行文献检索，检索了从数据库建立至2017年3月的7个数据库，无语言限制。所有入选研究均为随机临床试验（RCT），研究针刺对乳腺癌患者潮热和绝经症状的影响。使用Cochrane标准评估这些试验的方法学质量，并使用荟萃分析软件（RevMan 5.2）分析数据。
我们纳入了13项RCT中的844例乳腺癌患者（平均年龄：58岁）。根据改良的Jadad量表，这些试验质量为中到高。荟萃分析表明，针灸对潮热的频率和严重程度无显著影响（p = 0.34；p = 0.33），但能显著改善绝经症状（p = 0.009）。没有研究报告严重不良事件。
针灸能显著缓解绝经症状，但对潮热无效。担心激素疗法不良反应的乳腺癌患者可考虑针灸。进一步的大规模研究，同时测量生物标志物或细胞因子，可能有助于阐明针灸缓解乳腺癌患者绝经症状的机制。
