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针刺治疗癌症相关失眠:一项证据图谱研究。

Acupuncture for cancer-related insomnia: An evidence mapping.

作者信息

Guo Zining, Wang Liying, Wang Yuting, Liu Wenhao, Zhao Yi, Tang Xiaorong, Lin Run, Wu Zhennan, Cui Shaoyang, Xu Nenggui

机构信息

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

South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Integr Med Res. 2025 Dec;14(4):101225. doi: 10.1016/j.imr.2025.101225. Epub 2025 Aug 12.

Abstract

BACKGROUND

Acupuncture shows promise in treating cancer-related insomnia (CRI); however, the evidence level for its effectiveness remains low. This study systematically examined research quality and used evidence mapping (EM) to map and present evidence information to identify gaps and inform future research.

METHODS

Two reviewers searched eight databases from inception to May 2024, screened eligible randomized controlled trials (RCTs), and extracted key characteristics from included studies. The quality of studies was assessed using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool, and key characteristics visualized EM. Finally, Acupoint data were systematically summarized.

RESULTS

37 RCTs were included in this study. RoB 2.0 results showed only three studies at "low risk," while most had notable quality issues. EM indicated that common comparisons involved manual acupuncture (MA), alone or combined, versus sleep medications. Measures involved six assessment tools, with Pittsburgh Sleep Quality Index (PSQI) most frequently used. Meanwhile, EM revealed considerable uncertainty regarding acupuncture for CRI efficacy. Acupoint analysis identified Yintang (GV24+), Shenting (GV24), Baihui (GV20), Sanyinjiao (SP6), Neiguan (PC6), and Shenmen (HT7) as core acupoints. Analysis identified five key gaps: study reliability, participant selection, placebo effect, outcome measurement, and acupoint selection.

CONCLUSIONS

Research on acupuncture for CRI has various gaps, and more high-quality evidence is still needed. This study comprehensively mapped the current evidence on acupuncture for CRI and identified five key gaps, providing directions and references for future research.

PROTOCOL REGISTRATION

INPLASY, INPLASY202460052.

摘要

背景

针灸在治疗癌症相关失眠(CRI)方面显示出前景;然而,其有效性的证据水平仍然较低。本研究系统地检查了研究质量,并使用证据图谱(EM)来绘制和呈现证据信息,以识别差距并为未来研究提供参考。

方法

两名评审员检索了从数据库建立到2024年5月的八个数据库,筛选符合条件的随机对照试验(RCT),并从纳入的研究中提取关键特征。使用Cochrane偏倚风险2.0(RoB 2.0)工具评估研究质量,并通过关键特征可视化证据图谱。最后,系统地总结穴位数据。

结果

本研究纳入了37项RCT。RoB 2.0结果显示只有三项研究处于“低风险”,而大多数研究存在明显的质量问题。证据图谱表明,常见的比较包括单独或联合使用的手动针刺(MA)与睡眠药物。测量涉及六种评估工具,其中匹兹堡睡眠质量指数(PSQI)使用最为频繁。同时,证据图谱显示针灸治疗CRI疗效存在相当大的不确定性。穴位分析确定印堂(GV24+)、神庭(GV24)、百会(GV20)、三阴交(SP6)、内关(PC6)和神门(HT7)为核心穴位。分析确定了五个关键差距:研究可靠性、参与者选择、安慰剂效应、结果测量和穴位选择。

结论

针灸治疗CRI的研究存在各种差距,仍需要更多高质量的证据。本研究全面绘制了当前针灸治疗CRI的证据,并确定了五个关键差距,为未来研究提供了方向和参考。

方案注册

INPLASY,INPLASY202460052。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f4b/12398848/23aa0b2be3d7/gr1.jpg

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