电针治疗癌痛:随机临床试验的系统评价与荟萃分析
Electroacupuncture for the treatment of cancer pain: a systematic review and meta-analysis of randomized clinical trials.
作者信息
Zhang Junning, Wu Weizhen, Ren Yuehan, Yuan Yi, Jia Liqun
机构信息
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Department of Oncology of Integrative Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, China.
出版信息
Front Pain Res (Lausanne). 2023 May 15;4:1186506. doi: 10.3389/fpain.2023.1186506. eCollection 2023.
OBJECTIVE
This paper aims to review the current evidence on electroacupuncture as an effective and safe therapy for cancer pain management.
METHODS
Five databases were searched from their inception through November 11, 2022. Only the randomized controlled trials that meet the eligibility criteria were finally included in the study. Literature screening and data extraction were performed independently by two reviewers, and RevMan 5.3 used for meta-analysis.
RESULTS
A total of 17 RCTs met our inclusion criteria. We used 8 indicators to estimate the meta-analysis results, most of which proved statistically significant, including VAS scores, NRS scores, and KPS scores. To be specific, VAS scores (MD = -1.41, 95% CI: -2.42 to -0.41, = 0.006) and NRS scores (MD = -1.19, 95% CI: -1.72 to -0.66, < 0.0001) were significantly lower in the treatment group compared to the control group. The treatment group's KPS scores (MD = 5.48, 95% CI: 3.27 to 7.69, < 0.00001) were higher than those of the control group. Also, in the treatment group, the number of burst pain (MD = -2.66, 95% CI: -3.32 to -1.99, < 0.00001) and side effect rates (RR = 0.51, 95% CI: 0.39 to 0.67, < 0.00001) greatly reduced, while the response rate (RR = 1.17, 95% CI: 1.09 to 1.26, < 0.0001) significantly increased compared to the control group.
CONCLUSION
This study demonstrates the advantages of electroacupuncture in the treatment of cancer pain. Meanwhile, rigorous RCTs should be designed and conducted in the future to further demonstrate the exact efficacy of electroacupuncture.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022376148.
目的
本文旨在综述电针作为一种有效且安全的癌症疼痛管理疗法的现有证据。
方法
检索了五个数据库,检索时间从建库至2022年11月11日。最终纳入研究的仅为符合纳入标准的随机对照试验。由两名研究者独立进行文献筛选和数据提取,并使用RevMan 5.3进行荟萃分析。
结果
共有17项随机对照试验符合我们的纳入标准。我们使用8项指标来评估荟萃分析结果,其中大多数在统计学上具有显著意义,包括视觉模拟评分(VAS)、数字评分量表(NRS)和卡氏功能状态评分(KPS)。具体而言,与对照组相比,治疗组的VAS评分(MD = -1.41,95%CI:-2.42至-0.41,P = 0.006)和NRS评分(MD = -1.19,95%CI:-1.72至-0.66,P < 0.0001)显著更低。治疗组的KPS评分(MD = 5.48,95%CI:3.27至7.69,P < 0.00001)高于对照组。此外,治疗组的爆发性疼痛次数(MD = -2.66,95%CI:-3.32至-1.99,P < 0.00001)和副作用发生率(RR = 0.51,95%CI:0.39至0.67,P < 0.00001)大幅降低,而与对照组相比,缓解率(RR = 1.17,95%CI:1.09至1.26,P < 0.0001)显著提高。
结论
本研究证明了电针在治疗癌症疼痛方面的优势。同时,未来应设计并开展严谨的随机对照试验,以进一步证明电针的确切疗效。