Yu Mei-Ling, Qian Jia-Jia, Fu Shu-Ping, Chen Jia-Ying, Zheng Yu-Wen, Lu Zhi-Gang, Lu Sheng-Feng
First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, China.
Acupuncture and Rehabilitation College, Nanjing University of Chinese Medicine, Nanjing 210023, China.
Evid Based Complement Alternat Med. 2020 Jul 30;2020:5606823. doi: 10.1155/2020/5606823. eCollection 2020.
Cancer-induced bone pain (CIBP) is a highly prevalent symptom, which afflicts vast majority of patients who suffer from cancer. The current treatment options failed to achieve satisfactory effect and the side effects were prominent. Recent randomized controlled trials (RCTs) of animal demonstrate the benefit of acupuncture for CIBP. We sought to determine if the pooled data from available RCTs supports the use of acupuncture for CIBP.
A literature search for randomized controlled trials was conducted in six electronic databases from inception to May 31, 2019. Meta-analysis was performed with Review Manager 5.3 software; the publication bias was assessed by Stata 12.0 software. We used random effects model for pooling data because heterogeneity is absolute among studies to some extent.
Twenty-four trials were included in the review, of which 12 trials provided detailed data for meta-analyses. Preliminary evidence indicates that compared to wait list/sham group, acupuncture was effective on increasing paw withdrawal threshold (PWT) and paw withdrawal latency (PWL). Compared to medicine, acupuncture was less effective on PWT, but as effective as medicine on PWL. Acupuncture can reinforce medicine's effect on PWT and PWL. Compared to the control group, acupuncture was superior to increase body weight (BW), decrease spinal cord glial fibrillary acidic protein (GFAP), and interleukin-1 (IL-1). Furthermore, some studies showed acupuncture delay or partially reverse morphine tolerance. Three studies found acupuncture has no effect on PWT, but 2 of them found acupuncture could enhance small dose of Celebrex's effect on CIBP.
Acupuncture was superior to wait list/sham acupuncture on increasing PWT and has no less effect on increasing PWL compared to medicine; acupuncture improved the efficacy of drugs, increased the CIBP animals' body weight, and decreased their spinal cord GFAP and IL-1. High-quality studies are necessary to confirm the results.
癌症诱发的骨痛（CIBP）是一种非常普遍的症状，折磨着绝大多数癌症患者。目前的治疗方案未能取得令人满意的效果，且副作用显著。近期动物随机对照试验（RCT）表明针刺疗法对CIBP有益。我们试图确定现有RCT的汇总数据是否支持针刺疗法用于CIBP。
在六个电子数据库中进行了从建库至2019年5月31日的随机对照试验文献检索。使用Review Manager 5.3软件进行荟萃分析；通过Stata 12.0软件评估发表偏倚。由于研究之间在某种程度上存在绝对异质性，我们使用随机效应模型汇总数据。
本综述纳入了24项试验，其中12项试验提供了用于荟萃分析的详细数据。初步证据表明，与等待名单/假治疗组相比，针刺疗法在提高爪部撤离阈值（PWT）和爪部撤离潜伏期（PWL）方面有效。与药物相比，针刺疗法对PWT的效果较差，但对PWL的效果与药物相当。针刺疗法可增强药物对PWT和PWL的作用。与对照组相比，针刺疗法在增加体重（BW）、降低脊髓胶质纤维酸性蛋白（GFAP）和白细胞介素-1（IL-1）方面更具优势。此外，一些研究表明针刺疗法可延迟或部分逆转吗啡耐受性。三项研究发现针刺疗法对PWT无影响，但其中两项发现针刺疗法可增强小剂量塞来昔布对CIBP的作用。
针刺疗法在提高PWT方面优于等待名单/假针刺疗法，在提高PWL方面与药物效果相当；针刺疗法提高了药物疗效，增加了CIBP动物的体重，并降低了其脊髓GFAP和IL-1水平。需要高质量研究来证实这些结果。
Zotero 插件
