Zhang Yuzhu, Sun Yang, Li Dongmei, Liu Xiaoyuan, Fang Chen, Yang Chunmin, Luo Tianyu, Lu Hai, Li Huachao, Zhang Hongyan, Liang Qianyi, Wu Jiahua, Huang Limei, Xu Rui, Ren Liping, Chen Qianjun
Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Oncol. 2021 Jun 10;11:646315. doi: 10.3389/fonc.2021.646315. eCollection 2021.
The present systematic review and meta-analysis was undertaken to evaluate the effects of acupuncture in women with breast cancer (BC), focusing on patient-reported outcomes (PROs).
A comprehensive literature search was carried out for randomized controlled trials (RCTs) reporting PROs in BC patients with treatment-related symptoms after undergoing acupuncture for at least four weeks. Literature screening, data extraction, and risk bias assessment were independently carried out by two researchers.
Out of the 2, 524 identified studies, 29 studies representing 33 articles were included in this meta-analysis. At the end of treatment (EOT), the acupuncture patients' quality of life (QoL) was measured by the QLQ-C30 QoL subscale, the Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES), the Functional Assessment of Cancer Therapy-General/Breast (FACT-G/B), and the Menopause-Specific Quality of Life Questionnaire (MENQOL), which depicted a significant improvement. The use of acupuncture in BC patients lead to a considerable reduction in the scores of all subscales of the Brief Pain Inventory-Short Form (BPI-SF) and Visual Analog Scale (VAS) measuring pain. Moreover, patients treated with acupuncture were more likely to experience improvements in hot flashes scores, fatigue, sleep disturbance, and anxiety compared to those in the control group, while the improvements in depression were comparable across both groups. Long-term follow-up results were similar to the EOT results.
Current evidence suggests that acupuncture might improve BC treatment-related symptoms measured with PROs including QoL, pain, fatigue, hot flashes, sleep disturbance and anxiety. However, a number of included studies report limited amounts of certain subgroup settings, thus more rigorous, well-designed and larger RCTs are needed to confirm our results.
本系统评价和荟萃分析旨在评估针灸对乳腺癌(BC)女性患者的影响,重点关注患者报告结局(PROs)。
对随机对照试验(RCTs)进行全面文献检索,这些试验报告了BC患者在接受至少四周针灸治疗后与治疗相关症状的PROs。文献筛选、数据提取和风险偏倚评估由两名研究人员独立进行。
在2524项已识别的研究中,本荟萃分析纳入了29项研究(代表33篇文章)。在治疗结束时(EOT),通过QLQ-C30生活质量子量表、癌症治疗功能评估-内分泌症状(FACT-ES)、癌症治疗功能评估-通用/乳腺(FACT-G/B)和更年期特异性生活质量问卷(MENQOL)对针灸患者的生活质量(QoL)进行测量,结果显示有显著改善。在BC患者中使用针灸可使测量疼痛的简明疼痛量表简表(BPI-SF)和视觉模拟量表(VAS)所有子量表的得分大幅降低。此外,与对照组相比,接受针灸治疗的患者潮热评分、疲劳、睡眠障碍和焦虑更有可能得到改善,而两组在抑郁改善方面相当。长期随访结果与EOT结果相似。
目前的证据表明,针灸可能改善BC治疗相关症状,这些症状通过PROs测量,包括QoL、疼痛、疲劳、潮热、睡眠障碍和焦虑。然而,一些纳入研究报告的某些亚组设置数量有限,因此需要更严格、设计良好且更大规模的RCT来证实我们的结果。