Guilin Medical University, Campbell China Network, Guilin, China.
The Affiliated Tumor Hospital of Tianjin Medical University, Tianjin, China.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420940394. doi: 10.1177/1534735420940394.
To determine the efficacy of acupuncture on the management of hormone therapy-related side effects in breast cancer patients. Randomized controlled trials of acupuncture versus a control or placebo in breast cancer patients that examined reductions in therapy-related side effects were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library through April 2020. Data on patient symptoms (hot flashes, fatigue, pain, stiffness, and gastrointestinal symptoms), physical capacity, cytokines, and general psychosomatic well-being were analyzed. We evaluated and analyzed the quality of all included studies with the 5.2 Cochrane Handbook standards using Stata software (version 10.0) and Revman software (version 5.2), respectively. We assessed the risk of bias using the Cochrane Risk of Bias tool and evaluated the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. The pooled results suggested that acupuncture led to moderate improvements in hot flashes, fatigue, and stiffness. No significant differences were observed in pain, gastrointestinal symptoms, Kupperman index scores, Overall quality of life, tumor necrosis factor levels, and interleukin levels. Evidence for outcome indicators of symptom management were downgraded by the GRADE system for inconsistency, indirectness, and imprecision in the included RCTs. Nonetheless, acupuncture is a moderately appropriate alternative therapy for hormone therapy-related side effects in breast cancer patients. However, it still lacks large-sample, multicenter, prospective RCTs. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.
观察针刺治疗乳腺癌患者激素治疗相关副作用的疗效。
检索 2020 年 4 月前 PubMed、EMBASE、Web of Science 和 Cochrane 图书馆中收录的针刺与对照或安慰剂治疗乳腺癌患者、评估减少激素治疗相关副作用的随机对照试验。分析患者症状（热潮红、疲劳、疼痛、僵硬和胃肠道症状）、身体能力、细胞因子和一般身心福祉的数据。我们使用 Stata 软件（版本 10.0）和 Revman 软件（版本 5.2），分别按照 Cochrane 手册 5.2 标准评估和分析所有纳入研究的质量。我们使用 Cochrane 偏倚风险工具评估偏倚风险，并使用 GRADE（推荐评估、制定与评价）方法评估证据质量。
针刺组在热潮红、疲劳和僵硬方面有中度改善，但在疼痛、胃肠道症状、Kupperman 指数评分、总体生活质量、肿瘤坏死因子水平和白细胞介素水平方面无显著差异。纳入的 RCT 存在一致性、间接性和不精确性问题，因此，症状管理结局指标的证据质量被 GRADE 系统降级。尽管如此，针刺治疗仍是乳腺癌患者激素治疗相关副作用的一种中度合适的替代疗法。但是，目前仍缺乏大样本、多中心、前瞻性 RCT 研究。未来的研究应关注标准化对照组和治疗方法，至少采用单盲设计，评估生物学机制，具有足够的统计效力，并涉及多位针灸师。
