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不同针灸疗法治疗癌症相关疼痛的疗效与安全性：一项系统评价和网状Meta分析

Efficacy and Safety of Different Acupuncture Treatments for Cancer-Related Pain: A Systematic Review and Network Meta-Analysis.

作者信息

Xie Tianle, Liu Can, Wu Yudi, Li Xiuxiu, Yang Qianyun, Tan Jing

机构信息

Hunan University of Chinese Medicine, Changsha, Hunan, China.

出版信息

Integr Cancer Ther. 2025 Jan-Dec;24:15347354251314500. doi: 10.1177/15347354251314500.

DOI:10.1177/15347354251314500
PMID:39873173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11773549/
Abstract

BACKGROUND

Cancer pain is a prevalent and persistent issue, and while there have been some observations of the possible benefits of acupuncture in managing cancer pain, there is still debate regarding its safety and effectiveness. This study aims to compare the efficacy and safety of different acupuncture modalities in the treatment of cancer pain through a network meta-analysis.

METHODS

Between the time each database was created and June 3, 2024, eight databases were queried: PubMed, Cochrane, Embase, Web of Science, CNKI, Wanfang, VIP, and China Biomedicine. Randomized controlled trials investigating the use of various acupuncture and moxibustion techniques in the treatment of cancer pain were identified. Publication bias and quality of randomized controlled trials were assessed using the Cochrane Risk of Bias tool and the Jadad scale, and network meta-analyses were performed using Stata 15 and R 4.3.2.

RESULTS

We incorporated 111 studies encompassing 9549 individuals diagnosed with cancer, examining 29 distinct therapies. Network meta-analysis showed that, compared to Usual Medicine, Acupuncture + Usual Medicine + Traditional Chinese medicine (MD = -1.83, 95% CI: -2.86 to -0.80) could reduce NRS scores, Acupuncture + Traditional Chinese medicine (OR = 30.86, 95% CI: 3.75-254.20) could improve cancer pain relief, Moxibustion + Usual Medicine (MD = 2.12, 95% CI: 0.43-3.80) could effectively improve KPS score, Acupuncture + Application of Chinese medicine (OR = 0.16, 95% CI: 0.04-0.66) is associated with a lower incidence of constipation, Electro-Acupuncture + Usual Medicine (OR = 0.11, 95% CI: 0.03-0.45) shows a lower incidence of nausea and vomiting, Acupuncture + Moxibustion + Usual Medicine (OR = 0.29, 95% CI: 0.09-0.90) is associated with a lower incidence of dizziness.

CONCLUSION

Acupuncture + Traditional Chinese medicine is the best intervention for different acupuncture methods in the treatment of cancer pain, and Moxibustion + Usual Medicine is the best intervention to improve the quality of life of patients.

摘要

背景

癌痛是一个普遍且持续存在的问题，虽然已有一些关于针灸在管理癌痛方面可能具有益处的观察，但关于其安全性和有效性仍存在争议。本研究旨在通过网状Meta分析比较不同针灸方式治疗癌痛的疗效和安全性。

方法

在每个数据库创建至2024年6月3日期间，检索了八个数据库：PubMed、Cochrane、Embase、Web of Science、中国知网、万方、维普和中国生物医学数据库。纳入了调查各种针灸和艾灸技术治疗癌痛的随机对照试验。使用Cochrane偏倚风险工具和Jadad量表评估随机对照试验的发表偏倚和质量，并使用Stata 15和R 4.3.2进行网状Meta分析。

结果

我们纳入了111项研究，涉及9549名被诊断患有癌症的个体，考察了29种不同的疗法。网状Meta分析表明，与常规药物相比，针灸+常规药物+中药（MD = -1.83，95%CI：-2.86至-0.80）可降低数字评分量表（NRS）评分，针灸+中药（OR = 30.86，95%CI：3.75 - 254.20）可改善癌痛缓解情况，艾灸+常规药物（MD = 2.12，95%CI：0.43 - 3.80）可有效改善卡氏功能状态评分（KPS），针灸+中药外敷（OR = 0.16，95%CI：0.04 - 0.66）与便秘发生率较低相关，电针+常规药物（OR = 0.11，95%CI：0.03 - 0.45）显示恶心和呕吐发生率较低，针灸+艾灸+常规药物（OR = 0.29，95%CI：0.09 - 0.90）与头晕发生率较低相关。

结论

针灸+中药是不同针灸方法治疗癌痛的最佳干预措施；艾灸+常规药物是改善患者生活质量的最佳干预措施。

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