Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.
BMJ Support Palliat Care. 2021 Sep;11(3):264-270. doi: 10.1136/bmjspcare-2020-002638. Epub 2021 Jan 13.
Pain is one of the most common and problematic symptoms encountered by patients with cancer. Due to the multifactorial aetiology, pain management of these patients frequently requires multidisciplinary interventions including conventional support and specialty palliative care. Acupuncture has been identified as a possible adjunctive therapy for symptom management in cancer pain, and there is currently no systematic review focused solely on the evidence of acupuncture on cancer pain in palliative care.
To critically analyse currently available publications regarding the use of acupuncture for pain management among patients with cancer in palliative care settings.
Multiple academic databases were searched from inception to 29 October 2020. Randomised controlled trials involving acupuncture in palliative care for treatment of cancer-related pain were synthesised. Data were extracted by two independent reviewers, and methodological quality of each included study was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence.
Five studies (n=189) were included in this systematic review. Results indicated a favourable effect of acupuncture on pain relief in palliative care for patients with cancer. According to OCEBM 2011 Levels of Evidence, they were level 2 in one case (20%), level 3 in two cases (40%) and level 4 in the remaining (40%). Low-level evidence adversely affects the reliability of findings.
Acupuncture may be an effective and safe treatment associated with pain reduction in the palliative care of patients with cancer. Further high-quality, adequately powered studies are needed in the future.
疼痛是癌症患者最常见和最棘手的症状之一。由于病因的多因素性，这些患者的疼痛管理经常需要多学科干预，包括常规支持和专业姑息治疗。针灸已被确定为癌症疼痛症状管理的一种可能的辅助治疗方法，目前尚无专门针对姑息治疗中针灸治疗癌症疼痛证据的系统评价。
批判性分析目前关于姑息治疗中针灸治疗癌症患者疼痛管理的可用出版物。
从成立到 2020 年 10 月 29 日，检索了多个学术数据库。综合了姑息治疗中针灸治疗癌症相关疼痛的随机对照试验。两名独立审查员提取数据，并使用牛津循证医学中心（OCEBM）2011 年证据水平评估每个纳入研究的方法学质量。
本系统评价纳入了 5 项研究（n=189）。结果表明，针灸对癌症姑息治疗患者的疼痛缓解有有利影响。根据 OCEBM 2011 年证据水平，其中 1 项为 2 级（20%），2 项为 3 级（40%），其余 3 项为 4 级（40%）。低水平证据会对研究结果的可靠性产生不利影响。
针灸可能是一种有效的、安全的治疗方法，可减轻癌症姑息治疗患者的疼痛。未来需要更多高质量、充分有力的研究。
