针刺治疗乳腺癌患者全身治疗相关失眠：一项随机对照试验的系统评价和荟萃分析。

Acupuncture for systemic therapy-associated insomnia in patients with breast cancer: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Gao Lingling, Sun Ying, Luo Tianyu, Chen Huiying, Huang Shan, Zhu Ling, Ye Meixia

机构信息

Department of Surgery, Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine, Shenzhen, China.

出版信息

Front Oncol. 2025 May 8;15:1494929. doi: 10.3389/fonc.2025.1494929. eCollection 2025.

DOI:10.3389/fonc.2025.1494929

PMID:40406265

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12094943/

Abstract

BACKGROUND

Systemic therapy-associated insomnia is highly prevalent among patients with breast cancer. However, no meta-analysis has explored the efficacy of acupuncture for Systemic therapy-associated insomnia among patients with cancer.

METHODS

According to the PRISMA Statement, randomized controlled trials (RCTs) through April 2024 were identified and extracted from PubMed, Embase, and the Cochrane CENTRAL Register of Controlled Trials. The quality of the RCTs was assessed using the Cochrane Systematic Review Handbook 5.1 and its recommended risk-of-bias assessment tool. Two independent investigators screened and extracted the data and performed statistical analysis using RevMan5.3.

RESULTS

Of the total 411 studies identified, 4 RCTs were analyzed. The meta-analysis revealed that acupuncture significantly improved the total sleep time and sleep efficiency relative to wait-list control or sham EA among patients with breast cancer experiencing insomnia after systemic therapy (mean difference [MD] 29.86, 95% confidence interval [CI] 16.20-43.51, P < 0.0001 and MD 4.56, 95% CI 1.84-7.29, P = 0.001), reduced the pittsburgh sleep quality index (PSQI) relative to wait-list control or sham EA with an MD of -0.87 (95% CI -1.60 to -0.15, P = 0.02, I = 25%) in 4 weeks and an MD of -0.82 (95% CI -1.60 to -0.04, P = 0.04, I = 12%) in 8 weeks, and reduced the hospital anxiety and depression scale (HADS)-anxiety both in 4 weeks with an MD of -0.85 (95% CI -1.42 to -0.27, P = 0.004, I = 0%) and in 8 weeks with an MD of -0.94 (95% CI -1.56 to -0.32, P = 0.003, I = 0%. However, no significant differences in insomnia severity index (MD -2.15, 95% CI -5.07 to 0.78, P = 0.15 and MD -1.48, 95% CI -3.91 to 0.94, P = 0.23), and HADS-depression (MD -0.67, 95% CI -2.32 to 0.99, P = 0.43 and MD -0.63, 95% CI -2.39 to 1.12, P = 0.48) in 4 and 8 weeks were observed between the acupuncture group and the wait-list control or sham EA group.

CONCLUSION

Acupuncture has a great potential to be used in the management of systemic therapy-associated insomnia in patients with breast cancer. More studies with rigorous designs and larger sample sizes are warranted to verify the efficacy and safety of acupuncture for insomnia among patients with breast cancer.

摘要

背景

全身治疗相关失眠在乳腺癌患者中非常普遍。然而，尚无荟萃分析探讨针刺治疗癌症患者全身治疗相关失眠的疗效。

方法

根据PRISMA声明，检索并提取截至2024年4月来自PubMed、Embase和Cochrane对照试验中央注册库的随机对照试验（RCT）。使用Cochrane系统评价手册5.1及其推荐的偏倚风险评估工具评估RCT的质量。两名独立研究人员筛选并提取数据，并使用RevMan5.3进行统计分析。

结果

在总共识别出的411项研究中，分析了4项RCT。荟萃分析显示，与等待名单对照或假电针相比，针刺显著改善了全身治疗后出现失眠的乳腺癌患者的总睡眠时间和睡眠效率（平均差[MD]29.86，95%置信区间[CI]16.20 - 43.51，P < 0.0001；MD 4.56，95%CI 1.84 - 7.29，P = 0.001），在4周时相对于等待名单对照或假电针降低匹兹堡睡眠质量指数（PSQI），MD为 -0.87（95%CI -1.60至 -0.15，P = 0.02，I² = 25%），8周时MD为 -0.82（95%CI -1.60至 -0.04，P = 0.04，I² = 12%），并在4周和8周时均降低医院焦虑抑郁量表（HADS）-焦虑，4周时MD为 -0.85（95%CI -1.42至 -0.27，P = 0.004，I² = 0%），8周时MD为 -0.94（95%CI -1.56至 -0.32，P = 0.003，I² = 0%）。然而，针刺组与等待名单对照或假电针组在4周和8周时的失眠严重程度指数（MD -2.15，95%CI -5.07至0.78，P = 0.15；MD -1.48，95%CI -3.91至0.94，P = 0.23）以及HADS-抑郁（MD -0.67，95%CI -2.32至0.99，P = 0.43；MD -0.63，95%CI -2.39至1.12，P = 0.48）方面未观察到显著差异。