针灸治疗化疗引起的周围神经病变：一项荟萃分析和数据挖掘
Acupuncture in the treatment of chemotherapy-induced peripheral neuropathy: a meta-analysis and data mining.
作者信息
Li Limeng, Huang Yingxue, An Chengfei, Jing Ning, Xu Chuhan, Wang Xiaoyu, Li Huanan, Tan Tao
机构信息
Tuina Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
National Administration of Traditional Chinese Medicine Level Three Laboratory for Tuina Technique Biological Effects, Tianjin, China.
出版信息
Front Neurol. 2024 Oct 29;15:1442841. doi: 10.3389/fneur.2024.1442841. eCollection 2024.
BACKGROUND
The efficacy and acupoint selection of acupuncture in treating chemotherapy-induced peripheral neuropathy (CIPN) remain controversial. This study aims to explore the specific efficacy and acupoint selection of acupuncture in treating CIPN through a meta-analysis and data mining.
METHODS
Searching for clinical trials on acupuncture treatment for CIPN in 8 databases, evaluating its efficacy and safety through a meta-analysis, and exploring its acupoint selection through data mining.
RESULTS
The meta-analysis included 21 studies and 2,121 patients, showing that compared with the control group, the acupuncture group could significantly improve neuropathic pain intensity (SMD = -0.66, 95% CI [-1.07, -0.25], = 0.002), significantly reduce the NCI-CTCAE (MD = -0.29, 95%CI [-0.50, -0.08], < 0.01), significantly reduce the FACT-NXT score (MD = 2.09, 95% CI [0.73,3.45], < 0.05), significantly increase the motor conduction velocities (MCV) of median nerve (MD = 2.38, 95% CI [2.10, 2.67], < 0.001), the sensory conduction velocities (SCV) of the median nerve (MD = 0.56, 95 %CI [-1.45, 2.57], = 0.58), the SCV of the tibial nerve (MD = 1.78, 95% CI [0.50, 3.05], < 0.01), and the SCV of sural nerves (MD = 4.60, 95% CI [0.17, 9.02], < 0.05), as well as improving the quality of life score (MD =7.35, 95% CI [1.53, 13.18], = 0.01). Data mining showed that the core acupoints for acupuncture treatment of CIPN were LI4, ST36, LI11, LR3, and SP6.
CONCLUSION
Acupuncture can improve the neuropathic pain intensity, the intensity of the CIPN, MCV of the median nerve, SCV of the tibial nerve and peroneal nerve, quality of life, and has good safety in CIPN patients. LI4 (Hegu), ST36 (Zusanli), LI11 (Quchi), LR3 (Taichong), and SP6 (Sanyinjiao) are the core acupuncture points for treating CIPN, and this protocol has the potential to become a supplementary treatment for CIPN.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero, identifier CRD42024551137.
背景
针刺治疗化疗引起的周围神经病变（CIPN）的疗效及穴位选择仍存在争议。本研究旨在通过荟萃分析和数据挖掘探索针刺治疗CIPN的具体疗效和穴位选择。
方法
检索8个数据库中针刺治疗CIPN的临床试验，通过荟萃分析评估其疗效和安全性，并通过数据挖掘探索其穴位选择。
结果
荟萃分析纳入21项研究共2121例患者，结果显示与对照组相比，针刺组可显著改善神经病理性疼痛强度（标准化均数差[SMD]=-0.66，95%可信区间[-1.07，-0.25]，P=0.002），显著降低美国国立癌症研究所常见不良反应事件评价标准（NCI-CTCAE）分级（均数差[MD]=-0.29，95%可信区间[-0.50，-0.08]，P<0.01），显著降低功能评估癌症治疗-神经病变（FACT-NXT）评分（MD=2.09，95%可信区间[0.73，3.45]，P<0.05），显著提高正中神经运动传导速度（MCV）（MD=2.38，95%可信区间[2.10，2.67]，P<0.001）、正中神经感觉传导速度（SCV）（MD=0.56，95%可信区间[-1.45，2.57]，P=0.58）、胫神经SCV（MD=1.78，95%可信区间[0.50，3.05]，P<0.01）以及腓肠神经SCV（MD=4.60，95%可信区间[0.17，9.02]，P<0.05），同时改善生活质量评分（MD=7.35，95%可信区间[1.53，13.18]，P=0.01）。数据挖掘显示针刺治疗CIPN的核心穴位为合谷（LI4）、足三里（ST36）、曲池（LI11）、太冲（LR3）和三阴交（SP6）。
结论
针刺可改善CIPN患者的神经病理性疼痛强度、CIPN严重程度、正中神经MCV、胫神经和腓总神经SCV及生活质量，且安全性良好。合谷（LI4）、足三里（ST36）、曲池（LI11）、太冲（LR3）和三阴交（SP6）是治疗CIPN的核心穴位，该方案有可能成为CIPN的辅助治疗方法。
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