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压迫疗法预防化疗引起的周围神经病变:随机对照试验的系统评价与荟萃分析

Compression Therapy for Prevention of Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Wan Zhanhai, Huang Jiajie, Wang Xiumei, Li Peng

机构信息

Department of Anesthesiology and Operating Theater, The First Hospital of LanZhou University, Lanzhou, Gansu, People's Republic of China.

School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, People's Republic of China.

出版信息

J Pain Res. 2024 Dec 24;17:4509-4519. doi: 10.2147/JPR.S488470. eCollection 2024.

Abstract

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) significantly impairs the quality of life of patients undergoing chemotherapy and diminishes their adherence to the treatment regimen. Existing studies suggest that compression therapy may prevent the onset of CIPN, yet the specific efficacy remains to be conclusively determined.

METHODS

We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing compression therapy with inactive comparators in patients scheduled for chemotherapy. Evidence certainty was evaluated using the GRADE approach.

RESULTS

Analysis of four trials (442 patients) revealed that compression therapy reduced CIPN incidence (RR = 0.50, 95% CI: 0.33-0.76; absolute effect = -265, 95% CI: -355 to -127 per 1000) and depression (SMD = -0.83, 95% CI: -1.21 to -0.45) with moderate evidence and high adherence. No significant differences emerged in anxiety, sleep quality, or pain.

CONCLUSION

Moderate- to low-certainty evidence supports compression therapy's effectiveness in preventing CIPN and alleviating depression while showing no substantial impact on other outcomes.

LIMITATION

Evidence quality and quantity suggest potential bias, warranting additional RCTs to strengthen the evidence base.

摘要

背景

化疗引起的周围神经病变(CIPN)严重损害了接受化疗患者的生活质量,并降低了他们对治疗方案的依从性。现有研究表明,压迫疗法可能预防CIPN的发生,但其具体疗效仍有待最终确定。

方法

我们对比较压迫疗法与无活性对照物用于计划接受化疗患者的随机对照试验(RCT)进行了系统评价和荟萃分析。使用GRADE方法评估证据的确定性。

结果

对四项试验(442例患者)的分析显示,压迫疗法降低了CIPN的发生率(RR = 0.50,95%CI:0.33 - 0.76;绝对效应 = -265,95%CI:每1000例中-355至-127)以及抑郁程度(SMD = -0.83,95%CI:-1.21至-0.45),证据强度为中等,且依从性高。在焦虑、睡眠质量或疼痛方面未出现显著差异。

结论

中低确定性证据支持压迫疗法在预防CIPN和减轻抑郁方面的有效性,同时对其他结局无实质性影响。

局限性

证据的质量和数量表明可能存在偏倚,需要更多的随机对照试验来加强证据基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78e5/11681779/b56581c491d8/JPR-17-4509-g0001.jpg

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