Altern Ther Health Med. 2023 Nov;29(8):898-906.
Chemotherapy-induced peripheral neuropathy (CIPN), one of the most common adverse events associated with chemotherapy, may affect efficacy because of the interruption of chemotherapy or change of regimen in severe cases, and may even increase cancer mortality. Relevant data supports the evidence that acupuncture can treat pain and sensory abnormalities. However, choosing the most effective acupuncture therapy is difficult because of the lack of evidence-based medicine and comparisons between different acupuncture therapies for treating CIPN. The aim of this study was to use a network meta-analysis (NMA) to evaluate the efficacy of different acupuncture therapies for CIPN.
We searched Embase, PubMed, Web of Science, The Cochrane Library, The Chinese Journal Full Text Database, Chinese Biomedical Literature Database, and WanFang Database for randomized controlled trials (RCTs) of acupuncture for CIPN. The search period was from the creation of the relevant library to August 10, 2023. A total of 2 investigators independently performed literature screening, data extraction, and risk for bias evaluation. Stata 14.0 software (StataCorp LLC, College Station, Texas USA), was used for the NMA.
A total of 13 eligible RCTs involving 746 patients and 6 acupuncture therapies were included in the study. The NMA results showed that electroacupuncture was superior to moxibustion, manual acupuncture, acupoint injection and Western medicine in improving the total effective rate of treatment of CIPN; electroacupuncture + moxibustion was better than manual acupuncture, acupoint injection, and Western medicine. Manual acupuncture's total effective rate was better than Western medicine. However, electroacupuncture was the most effective treatment for CIPN according to the surface under the cumulative ranking curve (SUCRA) ranking.
After a comprehensive evaluation of 6 acupuncture therapies for treating CIPN based on NMA, electroacupuncture may be the best option for treating CIPN. However, would be more convincing to get evidence from more RCTs.
化疗引起的周围神经病（CIPN）是与化疗相关的最常见不良事件之一，在严重情况下，它可能会通过中断化疗或改变治疗方案来影响疗效，甚至会增加癌症死亡率。相关数据支持这样一种证据，即针灸可以治疗疼痛和感觉异常。然而，由于缺乏循证医学和不同针灸疗法治疗 CIPN 的比较，选择最有效的针灸疗法具有挑战性。本研究旨在使用网络荟萃分析（NMA）来评估不同针灸疗法治疗 CIPN 的疗效。
我们检索了 Embase、PubMed、Web of Science、The Cochrane Library、中国知网全文数据库、中国生物医学文献数据库和万方数据库中关于针灸治疗 CIPN 的随机对照试验（RCT）。检索期为相关库创建至 2023 年 8 月 10 日。两名研究者独立进行文献筛选、数据提取和偏倚风险评估。Stata 14.0 软件（StataCorp LLC，美国德克萨斯州科利斯顿）用于 NMA。
共有 13 项符合条件的 RCT 纳入了 746 名患者和 6 种针灸疗法。NMA 结果显示，电针对改善 CIPN 治疗总有效率优于艾灸、手动针刺、穴位注射和西药；电针+艾灸优于手动针刺、穴位注射和西药。手动针刺的总有效率优于西药。然而，根据累积排序曲线下面积（SUCRA）排名，电针对 CIPN 的治疗效果最佳。
基于 NMA 对 6 种针灸疗法治疗 CIPN 的综合评价，电针可能是治疗 CIPN 的最佳选择。然而，需要更多 RCT 证据才能更有说服力。
