Efficacy of integrative non-pharmacological traditional Chinese medicine approaches in enhancing gastrointestinal function and quality of life in patients undergoing chemotherapy: a systematic review and network meta-analysis.

BACKGROUND

The rising global incidence of cancer poses significant challenges for healthcare systems, necessitating the exploration of novel therapeutic strategies. This study involves a systematic review and network meta-analysis to evaluate the efficacy of non-pharmacological traditional Chinese medicine (TCM) interventions, such as acupuncture, electroacupuncture, and moxibustion, in improving gastrointestinal function and quality of life in patients undergoing chemotherapy.

METHODS

A comprehensive search was conducted across multiple databases up to March 13, 2024, to identify randomized controlled trials (RCTs) that involved the comparison of non-pharmacological TCM interventions with standard pharmacological treatments in adult patients with cancer undergoing chemotherapy. Primary outcomes included the quality of life measured by the Karnofsky Performance Status scale, gastrointestinal function measured by complete response rates, and objective response rates. Data were analyzed using Bayesian network meta-analysis methods, with outcomes presented as odds ratios (OR) and mean differences (MD) along with 95% credible intervals (CrIs).

RESULTS

A total of 37 RCTs involving 3268 participants were included in the review. The findings highlighted the significant efficacy of specific TCM interventions. The top-ranked intervention for improving Karnofsky Performance Status scores was electroacupuncture at the Geshu point combined with medication, with a surface under the cumulative ranking curve (SUCRA) value of 80.3%. For complete response rates, a combination of acupuncture, auricular point sticking, and medication emerged as the most effective method, with a SUCRA value of 88.0%. Additionally, for enhancing objective response rates, the combination of moxibustion at the Zusanli point and medication was identified as the leading intervention, with a SUCRA value of 80.3%.

CONCLUSION

Non-pharmacological TCM interventions were effective in significantly improving gastrointestinal function and quality of life in patients undergoing chemotherapy, representing modalities that viably complement standard pharmacological treatments. Our findings support the integration of these TCM practices into oncology care, emphasizing the need for further high-quality research to establish comprehensive clinical guidelines. This integrative strategy aligns with the principles of patient-centered care, promoting a more holistic approach to cancer treatment.