针灸治疗化疗引起的白细胞减少症的疗效和安全性：系统评价和荟萃分析。

Efficacy and safety of acupuncture for chemotherapy-induced leukopenia: A systematic review and meta-analysis.

机构信息

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

Affiliated Tumor Hospital of Zhengzhou University, Zhenzhou, Henan, China.

出版信息

Medicine (Baltimore). 2022 Oct 21;101(42):e30995. doi: 10.1097/MD.0000000000030995.

DOI:10.1097/MD.0000000000030995

PMID:36281119

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9592432/

Abstract

BACKGROUND

Leukopenia is one of most common types of myelosuppression secondary to chemotherapy. The main methods used to treat leukopenia after chemotherapy have various limitations. Several studies have reported the role of acupuncture in the prevention and treatment of leukopenia, but the quality of the study is uneven. Here, we used a systematic review and meta-analysis to evaluate the efficacy and safety of acupuncture in the treatment of leukopenia after chemotherapy.

METHODS

We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, Medline (via PubMed), EMBASE (via embase.com), the China National Knowledge Infrastructure Database (CNKI), the Chinese Biomedical Literature Database (CBM), the Chinese Scientific Journal Database (VIP database) and the Wanfang database to collect randomized clinical trials (RCTs) on acupuncture in the treatment of leukopenia after chemotherapy. Cochrane systematic reviewer manual 5.2 was used for bias risk assessment. RevMan5.3 statistical software was applied for statistical analysis.

RESULTS

Fifteen RCTs were included in this study, with a total of 1130 patients. Meta-analysis results showed that acupuncture can increase white blood cell (WBC) count after chemotherapy [MD = 1.18, 95% CI (0.80, 1.57), P < .00001], reduce the incidence of myelosuppression [RR = 0.38, 95% CI (0.23, 0.63), P = .0002], and improve the clinical treatment effectiveness [RR = 1.20, 95% CI (1.00, 1.43), P = .05]. The differences were statistically significant.

CONCLUSION

It is recommended to use acupuncture in the treatment of leukocytopenia after chemotherapy, but this result needs further research for verification.

摘要

背景

白细胞减少症是化疗引起的骨髓抑制中最常见的类型之一。治疗化疗后白细胞减少症的主要方法各有局限性。有几项研究报道了针刺在预防和治疗白细胞减少症中的作用，但研究质量参差不齐。在这里，我们使用系统评价和荟萃分析来评估针刺治疗化疗后白细胞减少症的疗效和安全性。

方法

我们检索了 Cochrane 对照试验中心注册库（CENTRAL）、Cochrane 图书馆、Medline（通过 PubMed）、EMBASE（通过 embase.com）、中国国家知识基础设施数据库（CNKI）、中国生物医学文献数据库（CBM）、中国科学期刊数据库（VIP 数据库）和万方数据库，以收集针刺治疗化疗后白细胞减少症的随机对照试验（RCT）。使用 Cochrane 系统评价员手册 5.2 进行偏倚风险评估。使用 RevMan5.3 统计软件进行统计分析。

结果

本研究共纳入 15 项 RCT，共 1130 例患者。Meta 分析结果表明，针刺可增加化疗后白细胞（WBC）计数[MD=1.18，95%CI（0.80，1.57），P<0.00001]，降低骨髓抑制发生率[RR=0.38，95%CI（0.23，0.63），P=0.0002]，提高临床治疗效果[RR=1.20，95%CI（1.00，1.43），P=0.05]。差异有统计学意义。