Choi Tae-Young, Ang Lin, Jun Ji Hee, Alraek Terje, Lee Myeong Soo
KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
School of Health Sciences, Kristiania University College, 0107 Oslo, Norway.
Cancers (Basel). 2022 May 10;14(10):2347. doi: 10.3390/cancers14102347.
Although acupuncture (AT) is used in the treatment of CRF, the evidence from different systematic reviews (SRs) of AT has not yet been comprehensively evaluated. Moxibustion, which is a treatment method that is well established within Traditional East Asian Medicine, applies the heat of burning herbs towards or onto special points on the skin. Commonly, the herb Artemisia vulgaris, is used. It has been used for palliative cancer care, as well as for CRF. The aim of this overview was to evaluate the efficacy of AT and moxibustion in the management of CRF. Eleven databases were searched through for studies that were published from their dates of inception to February 2022. The study selection, the data extraction, and the assessment were performed independently by two researchers. The methodological and report quality were assessed by using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. The evidence quality was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Fifteen SRs on AT (n = 10) and moxibustion (n = 5) treatments for CRF were included, and they include 169 randomized controlled trials and 14,392 participants. All of the SRs that were evaluated by the AMASTAR-2 had more than one deficiency, and so all of the SRs were rated as either low or critically low. For the GRADE, 18 outcomes were rated as very-low-quality evidence, 13 as low-quality evidence, 3 as moderate-quality evidence, and 0 as high-quality evidence. Most of the SRs reached the potential benefits of AT for CRF. No serious adverse effects were identified. In conclusion, the evidence suggests that, despite the advantages of AT in terms of the improvement in and the safety of the treatment of CRF, the methodological quality of most of these studies is low, which limits our ability to draw definitive meanings. Further research of high quality is needed in order to confirm these findings.
尽管针灸被用于慢性肾衰竭（CRF）的治疗，但来自不同针灸系统评价（SRs）的证据尚未得到全面评估。艾灸是东亚传统医学中一种成熟的治疗方法，它将燃烧草药产生的热量施用于皮肤上的特定穴位或穴位之上。通常使用的草药是艾草。艾灸已被用于癌症姑息治疗以及慢性肾衰竭的治疗。本综述的目的是评估针灸和艾灸在慢性肾衰竭管理中的疗效。通过检索11个数据库，查找从各数据库建立之日至2022年2月发表的研究。由两名研究人员独立进行研究筛选、数据提取和评估。使用多重系统评价评估工具2（AMSTAR - 2）评估方法学和报告质量。使用推荐分级评估、制定和评价（GRADE）系统评估证据质量。纳入了15项关于针灸（n = 10）和艾灸（n = 5）治疗慢性肾衰竭的系统评价，其中包括169项随机对照试验和14392名参与者。所有经AMASTAR - 2评估的系统评价都存在不止一处缺陷，因此所有系统评价的评级均为低或极低。对于GRADE，18项结果被评为极低质量证据，13项为低质量证据，3项为中等质量证据，0项为高质量证据。大多数系统评价得出针灸对慢性肾衰竭有潜在益处的结论。未发现严重不良反应。总之，证据表明，尽管针灸在改善慢性肾衰竭治疗效果和安全性方面具有优势，但这些研究大多方法学质量较低，这限制了我们得出明确结论的能力。需要进一步开展高质量研究以证实这些发现。
