School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China; Department of Nursing, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong Province, China.
Eur J Oncol Nurs. 2022 Jun;58:102124. doi: 10.1016/j.ejon.2022.102124. Epub 2022 Mar 29.
This systematic review was conducted to evaluate the best available evidence regarding the use of non-invasive neuromodulation techniques for managing chemotherapy-induced peripheral neuropathy (CIPN).
A systematic literature search of the following databases from their inception to October 17, 2021 was performed and was updated on March 2, 2022: AMED via Ovid, CINAHL via the EBSCO Host, Cochrane Library, Embase, PEDro, PubMed, and Web of Science. Randomized controlled trials (RCTs) and quasi-experimental studies examining the safety, feasibility, and efficacy of non-invasive neuromodulation techniques for managing established CIPN were identified. Narrative synthesis was used to analyze data collected from the included studies.
Nine RCTs and nine quasi-experimental studies were included. A variety of non-invasive peripheral and central neuromodulation techniques were investigated in those studies, including scrambler therapy, electrical stimulations, photobiomodulation, magnetic field therapy, therapeutic ultrasound, neurofeedback, and repetitive transcranial magnetic stimulation. Non-invasive neuromodulation techniques for the management of established CIPN are generally safe and feasible. The efficacy of peripheral neuromodulation techniques such as scrambler therapy and transcutaneous electrical nerve stimulation was mostly unsatisfactory, while central neuromodulation techniques such as neurofeedback and repetitive transcranial magnetic stimulation were promising.
The use of non-invasive neuromodulation techniques for managing CIPN is still in its infancy. Non-invasive central neuromodulation techniques have significant potential for relieving chronic pain and neuropathic symptoms related to CIPN, meriting further exploration.
本系统评价旨在评估非侵入性神经调节技术用于治疗化疗诱导的周围神经病（CIPN）的最佳现有证据。
从各数据库创建起至 2021 年 10 月 17 日对以下数据库进行了系统文献检索，并于 2022 年 3 月 2 日进行了更新：通过 Ovid 访问的 AMED、通过 EBSCO 主机访问的 CINAHL、 Cochrane 图书馆、Embase、PEDro、PubMed 和 Web of Science。纳入了评估非侵入性神经调节技术治疗既定 CIPN 的安全性、可行性和疗效的随机对照试验（RCT）和准实验研究。使用叙述性综合法分析了纳入研究中收集的数据。
纳入了 9 项 RCT 和 9 项准实验研究。这些研究调查了多种非侵入性外周和中枢神经调节技术，包括乱序仪疗法、电刺激、光生物调节、磁场疗法、治疗性超声、神经反馈和重复经颅磁刺激。用于治疗既定 CIPN 的非侵入性神经调节技术通常是安全且可行的。外周神经调节技术（如乱序仪疗法和经皮电神经刺激）的疗效大多不尽如人意，而中枢神经调节技术（如神经反馈和重复经颅磁刺激）则有很大的潜力。
非侵入性神经调节技术用于治疗 CIPN 仍处于起步阶段。非侵入性中枢神经调节技术在缓解与 CIPN 相关的慢性疼痛和神经病理性症状方面具有很大的潜力，值得进一步探索。
